超声造影对桥本氏甲状腺炎背景下良恶性结节的诊断价值

目的:探讨超声造影(CEUS)对桥本氏甲状腺炎(HT)背景下甲状腺结节的诊断价值.方法:对78例(101个)经手术病理证实的桥本氏甲状腺炎背景下甲状腺结节的超声造影,采用 TomTec 软件进行量化分析,获得造影参数:始增时间、达峰时间和最大峰值强度,比较良性组与恶性组之间的差异.结果:HT背景下101个结节中,良性63个,恶性38个.恶性结节的超声造影增强特征以不均匀增强、低增强为主,良性结节以环状增强、均匀增强、等增强多见.超声造影参数恶性组与良性组始增时间(AT)、达峰时间(TTP)差异无统计学意义(P>0.05),峰值强度(IMAX)的差异有统计学意义(P<0.05).CEUS诊断HT背景下甲状腺结节的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为92.1%、95.2%、92.1%、95.2%、94.1%.结论:超声造影可以提高桥本氏甲状腺炎背景下甲状腺结节的诊断准确性.

Value of contrast-enhanced ultrasonography in the differential diagnosis of thyroid nodules under the background of Hashimoto's thyroiditis

Objective:To evaluate the value of the differential diagnosis of thyroid nodules under the background of Hashimoto's thyroiditis(HT) using contrast-enhanced ultrasonography (CEUS).Methods:Totally 101 thyroid nodules in 78 HT patients confirmed by operations and pathology were given CEUS examination.The parameters as follows:Rise time(RT),time to peak (TTP),and maximum intensity(IMAX)were compared by using TomTec analysis software.Results:In 101 nodules,there were 63 benign thyroid nodules,and 38 malignant thyroid nodules.Most malignant nodules showed inhomogeneous enhancement and hypo-enhancement,while most benign nodules showed circular enhancement,homogeneous enhancement and homo-enhancement.There were no significant differences in RT or TTP between the two groups,while IMAX was higher in benign nodules than those in malignant nodules(P<0.05).The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),and accuracy of CEUS in diagnosis of benign and malignant thyroid nodules with HT were 92.1%,95.2%,92.1%,95.2%,and 94.1%.Conclusion:CEUS can improve the diagnostic accuracy in the distinguishing thyroid nodules under the background of HT.