摘要
目的探讨常规超声(US)联合超声造影(CEUS)对桥本甲状腺炎患者甲状腺良恶性结节的鉴别诊断价值,以为后续治疗方案的制定提供参考。方法以2018年10月至2021年4月收治的60例合并甲状腺良恶性结节的桥本甲状腺炎患者作为研究对象,均实施US、CEUS及病理诊断。分析桥本甲状腺炎患者甲状腺良恶性结节的病理诊断结果;比较桥本甲状腺炎患者甲状腺良恶性结节的US、CEUS特征;比较CEUS下桥本甲状腺炎患者甲状腺良恶性结节的时间-强度曲线参数;以病理诊断结果为金标准,分析US联合CEUS对桥本甲状腺炎患者甲状腺恶性结节的诊断效能。结果60例合并甲状腺良恶性结节的桥本甲状腺炎患者中,共检出结节69个,其中良性结节20个、恶性结节49个。US显示,良性结节、恶性结节的血流分布、内部回声、微小钙化、纵横比、边界比较,差异具有统计学意义(P<0.05)。CEUS显示,良性结节、恶性结节的消退方式、环状增强、内部增强方式、增强强度、增强模式比较,差异具有统计学意义(P<0.05)。CEUS下,恶性结节的峰值强度低于良性结节,渡越时间短于良性结节,差异具有统计学意义(P<0.05);良性结节、恶性结节的达峰时间、始增时间比较,差异无统计学意义(P>0.05)。US联合CEUS诊断桥本甲状腺炎患者甲状腺恶性结节的灵敏度为95.92%,特异度为85.00%,准确度为92.75%,阳性预测值为94.00%,阴性预测值为89.47%。结论US、CEUS联合用于桥本甲状腺炎患者甲状腺良恶性结节的鉴别诊断中,能够较好地反映病灶特点,应用价值较高。
Objective To explore the differential diagnosis value of conventional ultrasound(US)combined with contrast-enhanced ultrasound(CEUS)in benign and malignant thyroid nodules in patients with Hashimoto thyroiditis,so as to provide reference for the formulation of follow-up treatment plans.Methods A total of 60 patients with Hashimoto thyroiditis complicated with benign and malignant thyroid nodules admitted from October 2018 to April 2021 were taken as the research objects,and the US,CEUS and pathological diagnosis were performed.The pathological diagnosis results of benign and malignant thyroid nodules in patients with Hashimoto thyroiditis was analyzed;the US and CEUS characteristics of benign and malignant thyroid nodules in patients with Hashimoto thyroiditis were compared;the time intensity curve parameters of benign and malignant thyroid nodules in patients with Hashimoto thyroiditis under CEUS were compared;taking pathological diagnosis results as the gold standard,the diagnostic efficacy of US combined with CEUS for malignant thyroid nodules in patients with Hashimoto thyroiditis was analyzed.Results In 60 patients with Hashimoto thyroiditis complicated with benign and malignant thyroid nodules,69 nodules were detected,including 20benign nodules and 49 malignant nodules.US showed that there were significant differences in the blood flow distribution,internal echo,microcalcification,aspect ratio and boundary between benign nodules and malignant nodules(P<0.05).CEUS showed that there were significant differences in the regression mode,annular enhancement,internal enhancement mode,enhancement intensity and enhancement mode between benign nodules and malignant nodules(P<0.05).Under CEUS,the peak intensity of malignant nodules was lower than that of benign nodules,the transit time was shorter than that of benign nodules,and the differences were statistically significant(P<0.05);there were no significant differences in peak time and initial increase time between benign nodules and malignant nodules(P>0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of US combined with CEUS in the diagnosis of malignant thyroid nodules in patients with Hashimoto thyroiditis were 95.92%,85.00%,92.75%,94.00%and 89.47%,respectively.Conclusion US combined with CEUS in the differential diagnosis of benign and malignant thyroid nodules in patients with Hashimoto thyroiditis can better reflect the characteristics of lesions and has high application value.
作者
孙佩佩
蔡永胜
SUN Peipei;CAI Yongsheng(Xi'an International Medical Center Hospital,Xi'an 710100,China)
出处
《临床医学研究与实践》
2022年第28期115-118,共4页
Clinical Research and Practice
关键词
常规超声
超声造影
桥本甲状腺炎
甲状腺良恶性结节
conventional ultrasound
contrast-enhanced ultrasound
Hashimoto thyroiditis
benign and malignant thyroid nodules
