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| 定量分析对常规超声联合超声造影定性误诊甲状腺结节的诊断价值 |
| 李亮,荣新,张文,金晶,卓双双,周悦,戚庭月,鞠萍,王正,张凤霞 |
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| (连云港市第二人民医院超声科;扬州大学附属医院医学影像中心超声科;扬州大学附属医院病理科;扬州大学附属医院甲乳外科) |
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| 摘要: |
| 摘要：目的：探讨超声造影（CEUS）定量分析对常规超声联合CEUS定性诊断误诊为恶性的甲状腺结节与甲状腺乳头状癌的鉴别诊断价值。方法：选取2018年7月至2021年11月在我院超声科行甲状腺常规超声及CEUS检查，术前联合超声诊断为恶性（C-TIRADS≥4b 或 CEUS 表现为低增强和快速消退任一征像）而病理为良性的35位患者共35个结节为研究组；选择同期联合超声诊断与病理一致的甲状腺乳头状癌患者47例做为对照组。分析常规超声及CEUS特征，并将结节整体、中央部、边缘部及邻近正常甲状腺实质作为感兴趣区分别绘制时间-强度曲线（TIC）进行定量分析，比较两组结节各定量参数之间的差异。结果：研究组整体相对上升时间（△RT）以0.45为截断值，诊断恶性结节的敏感度为97.9%，特异度为85.7%，受试者工作（ROC）曲线下面积为0.96；研究组中央区△RT以0.55为截断值，诊断恶性结节的敏感度为95.7%，特异度为82.9%，ROC曲线下面积为0.87；研究组边缘区△RT以0.25为截断值，诊断恶性结节的敏感度为89.4%，特异度为77.1%，ROC曲线下面积为0.89。结论：CEUS定量分析在常规超声联合CEUS定性误诊甲状腺结节的诊断中具有一定的鉴别诊断价值。 |
| 关键词: 甲状腺结节 超声造影 常规超声联合超声造影 时间-强度曲线 鉴别价值 |
| DOI： |
| 投稿时间：2022-06-17修订日期：2022-07-30 |
| 基金项目:扬州市重点研发项目(YZ2020099) |
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| Study on the diagnostic value of quantitative analysis in misdiagnosis of thyroid nodules by conventional ultrasound combined with qualitative diagnosis of contrast-enhanced ultrasound |
| Li Liang,Rong Xin,Zhang Wen,Jin Jing,Zhuo Shuangshuang,Zhou Yue,Qi Tingyue,Ju Ping,Wang Zheng,Zhang Fengxia |
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| Abstract: |
| Abstract Objective To explore the differential diagnosis value of CEUS quantitative analysis in the diagnosis of malignant thyroid nodules and thyroid papillary carcinoma misdiagnosed by conventional ultrasound combined with CEUS.
Methods: A total of 35 nodules were selected from 35 patients who underwent conventional thyroid ultrasound and CEUS examination in the ultrasound department of our hospital from July 2018 to November 2021 and were diagnosed as malignant by preoperative combined ultrasound (C-TIRADS≥4b or CEUS with either low enhancement or rapid regression) but pathologically benign. A total of 47 patients with thyroid papillary carcinoma diagnosed by combined ultrasound at the same time and consistent with pathology were selected as control group. The characteristics of conventional ultrasound and CEUS were analyzed. The whole nodule, the central part, the marginal part and the adjacent normal thyroid parenchyma were used as areas of interest to draw time-intensity curves (TIC) for quantitative analysis, and the differences of quantitative parameters between the two groups of nodule were compared. Results The whole relative rise time (△RT) of the study group was 0.45 as the cut-off value，the sensitivity and specificity of malignant nodules were 97.9%, 85.7%, and the area under receiver operating characteristic (ROC) curve was 0.96. In the central region of the study group, △RT was used as the cut-off value of 0.55，the sensitivity and specificity of malignant nodules were 95.7%, 82.9%, and the area under ROC curve was 0.87. The sensitivity, specificity and area under ROC curve of malignant nodules were 89.4%, 77.1% and 0.89, respectively, with 0.25 as cut-off value of △RT at the peripherization of the study group. Conclusion: Quantitative analysis by CEUS has a certain value in differential diagnosis of thyroid nodules misdiagnosed by conventional ultrasound combined with qualitative diagnosis by CEUS. |
| Key words: ：Thyroid nodules Contrast-enhanced ultrasound Conventional ultrasound combined with CEUS Time-intensity curve Identify the value |
