摘要
目的探讨超声造影在甲状腺微小乳头状癌(PTMC)中的诊断价值。方法本研究为回顾性病例对照研究,选取2020年1月至2024年12月于北部战区总医院超声诊断科行超声造影检查的甲状腺结节切除术患者175例(结节175个),男42例,女133例,年龄(45.35±16.72)岁,年龄范围为22~78岁。根据病理结果,良性结节的86例患者为良性组,PTMC的89例患者为PTMC组。采用受试者操作特征(ROC)曲线评价常规超声、超声造影检查及二者联合诊断PTMC的诊断效能,分析PTMC的超声造影特征,分析超声造影达峰时间与微血管密度(MVD)的相关性。结果常规超声、超声造影及二者联合诊断PTMC的ROC曲线下面积为0.869(95%CI:0.810~0.915)、0.909(95%CI:0.856~0.947)、0.938(95%CI:0.891~0.969)。二者联合诊断PTMC的灵敏度为91.75%、特异度为94.67%、准确度为94.67%。PTMC组低增强结节比例[92.1%(82/89)]、增强不均匀结节比例[85.4%(76/89)]、快速消退结节比例[78.7%(70/89)]高于良性组[62.8%(54/86)、34.9%(30/86)、37.2%(32/86)],PTMC组达峰时间[(15.28±2.30)s]短于良性组[(22.65±3.45)s],差异有统计学意义(P<0.05)。PTMC组的MVD[(28.60±4.19)/HPF]高于良性结节[(15.25±3.42)/HPF],差异有统计学意义(P<0.05)。超声造影达峰时间与MVD呈负相关(r=-0.648,P=0.001)。结论常规超声联合超声造影对PTMC具有良好的诊断效能,PTMC超声造影特点以"不均匀低增强"为主,达峰时间短,可快速消退。
ObjectiveTo explore the diagnostic value of contrast-enhanced ultrasound in papillary thyroid microcarcinoma(PTMC).MethodsThis study was a retrospective case-control study,a total of 175 patients(175 nodules)who underwent contrast-enhanced ultrasound in the department of Ultrasound Diagnosis at the General Hospital of the Northern Theater Command from January 2020 to December 2024 were selected,including 42 males and 133 females,aged(45.35±16.72)years old,ranging from 22 to 78 years old.According to the pathological results,there were 86 patients with benign nodules classified as the benign group,and 89 patients with PTMC were classified as the PTMC group.The receiver operator characteristic(ROC)curve was used to evaluate the diagnostic efficacy of conventional ultrasound,contrast-enhanced ultrasound and the combination of the two in diagnosing PTMC.The contrast-enhanced ultrasound characteristics of PTMC were analyzed.The correlation between the peak time of contrast-enhanced ultrasound and micro-vascular density(MVD)were analyzed.ResultsThe areas under the ROC curves of conventional ultrasound,contrast-enhanced ultrasound and the combination of the two for the diagnosis of PTMC were 0.869(95%CI:0.810 to 0.915),0.909(95%CI:0.856 to 0.947),and 0.938(95%CI:0.891 to 0.969),respectively.The combination of the two for the diagnosis of PTMC had a sensitivity of 91.75%,a specificity of 94.67%,and an accuracy of 94.67%.The proportion of low enhanced nodule[92.1%(82/89)],uneven nodules[85.4%(76/89)],fading fast nodule[78.7%(70/89)]in PTMC group were higher than those in benign group[62.8%(54/86),34.9%(30/86),37.2%(32/86)],the peak time of the PTMC group[(15.28±2.30)s]was shorter than that of the benign group[(22.65±3.45)s],and the differences were statistically significant(P<0.05).The MVD in the PTMC group[(28.60±4.19)/HPF]was higher than that in the benign nodules group[(15.25±3.42)/HPF],and the difference was statistically significant(P<0.05).The peak time of contrast-enhanced ultrasound was negatively correlated with the MVD(r=-0.648,P=0.001).ConclusionsConventional ultrasound combined with contrast-enhanced ultrasound has a good diagnostic efficacy for PTMC.The contrast-enhanced ultrasound characteristics of PTMC are mainly"uneven low enhancement",with a short peak time and rapid regression.
作者
苏晓妮
金壮
李玥
蒋南
于馨
鲁超
Su Xiaoni;Jin Zhuang;Li Yue;Jiang Nan;Yu Xin;Lu Chao(Department of Ultrasound Diagnosis,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《中国临床实用医学》
2025年第5期329-332,共4页
China Clinical Practical Medicine
基金
辽宁省科学技术计划项目(2024JH2/102600299)
沈阳市科技计划项目(24-214-3-171)。
关键词
甲状腺微小乳头状癌
超声造影
微血管密度
诊断效能
Papillary thyroid microcarcinoma
Contrast-enhanced ultrasound
Micro-vascular density
Diagnostic efficacy
