| 摘要: |
| 目的 探讨常规超声、声触诊组织量化成像（VTIQ）及超声造影（CEUS）在鉴别甲状腺木乃伊良性结节与甲状腺乳头状癌恶性结节中的价值。
方法 收集23例甲状腺木乃伊良性结节和17例甲状腺乳头状癌恶性结节，利用常规超声、VTIQ及CEUS技术对结节的大小、形态、边界、回声、钙化、声影、黑白双层晕环征、血流、VTIQ和CEUS等参数进行比较和分析。
结果 23例甲状腺木乃伊结节， 5例经手术证实为良性，18例经细针穿刺（FNA）证实为良性。单因素分析发现甲状腺木乃伊结节较乳头状癌结节更易出现黑白双层晕环征，周边或内部血流信号，较小的剪切波速度（SWV）值，CEUS无或低增强模式，峰值强度比<1和曲线下面积比<1等超声表现（p<0.05）。ROC曲线得到木乃伊结节和乳头状癌的SWV截断值为3.69m/s。Logistic回归分析发现具备黑白双层晕环征和峰值强度比<1是甲状腺木乃伊结节鉴别于乳头状癌的相关超声表现（p<0.05）。
结论 甲状腺良性结节萎缩后可以呈现出恶性结节的超声特征。掌握这些结节的超声表现并结合既往相关的超声检查结果对于检出这些类似恶性结节的良性结节至关重要。 |
| 关键词: 甲状腺木乃伊结节，甲状腺乳头状癌，常规超声，声触诊弹性成像，超声造影 |
| DOI： |
| 投稿时间：2019-07-22修订日期：2019-08-02 |
| 基金项目:湖南省自然科学基金(2017JJ3443, 2018JJ2575), 湖南省卫生健康委科研基金项目(B2019166)。 |
|
| Sonographic characteristics of mummified thyroid nodules：conventional ultrasound, virtual touch imaging and quantification, and contrast-enhanced ultrasound |
| CHEN Sijie,NIU Chengcheng,PENG Qinghai,LIU Minghui |
| (Department of Ultrasound,The Second Xiangya Hospital,Central South University) |
| Abstract: |
| Objective To explore the value of sonographic characteristics of mummified thyroid nodules in differentiating from histologically proven papillary thyroid carcinomas (PTCs), including conventional ultrasound (US), virtual touch imaging and quantification (VTIQ) and contrast-enhanced ultrasound (CEUS). Methods Twenty-three mummified thyroid nodules and seventeen PTCs were enrolled in this study. We evaluated the size, shape, margin, echogenicity, calcification, posterior shadowing, black and white double halo, vascularity, VTIQ and CEUS parameters for each nodule. Results Of the 23 mummified thyroid nodules, 5 were confirmed as benign by surgery, 18 were proved as benign by fine-needle aspiration (FNA). Univariate analysis indicated that mummified thyroid nodules more frequently showed presence of black and white double halo, peripheral or nodular vascularity, relatively softer stiffness with a lower shear wave velocity (SWV), hypo- or no enhancement, peak intensity index <1 and area under the curve (AUC) index <1 at preoperative US, VTIQ and CEUS than PTCs (all p<0.05). The VTIQ parameter of the SWV mean with a cutoff value of 3.69 m/s. Binary logistic regression analysis showed presence of black and white double halo, SWV <3.69m/s and peak intensity index <1 were independent characteristics related to mummified thyroid nodules for discriminating from PTCs (all p<0.05). Conclusions Mummified thyroid nodules may display shrinkage over time and reveal malignant sonograghic features. Mastering the ultrasound findings of these nodules and combining previous ultrasound findings are critical for detecting benign nodules from malignant nodules. |
| Key words: mummified thyroid nodules papillary thyroid carcinomas conventional ultrasound virtual touch imaging and quantification contrast-enhanced ultrasound. |
