超声造影鉴别合并钙化灶的甲状腺结节良恶性的价值
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摘要
目的探讨超声造影鉴别合并钙化灶的甲状腺结节良恶性的临床价值。方法回顾性分析我院经手术病理证实伴有钙化灶的92例甲状腺结节患者的超声资料,比较良、恶性甲状腺结节的超声造影表现。结果 51例恶性结节中,41例伴微钙化,10例伴粗大钙化,弱增强及不均匀增强比例分别为82.4%、88.2%;41例良性结节中,11例伴微钙化,30例伴粗大钙化弱增强及不均匀增强比例分别为9.8%、14.6%;恶性结节微钙化比例、超声造影特征弱增强及不均匀增强比例均显著高于良性结节,差异均有统计学意义(均P<0.05);良恶性甲状腺结节峰值强度分别为(107.21±20.33)d B、(69.47±16.34)d B,差异有统计学意义(P<0.05);但二者间始增时间及达峰时间比较差异无统计学意义。结论超声造影可显示合并钙化灶的甲状腺结节,且恶性病变较多,具有一定的特征性表现。其对合并钙化灶的甲状腺结节的诊断具有较高的临床价值。
Objective To explore the clinical value of contrast-enhanced ultrasound in the differential diagnosis of benign and malignant thyroid nodules with calcified lesions. Methods Retrospective analyzed the ultrasonic data of 92 patients with thyroid nodules complicated with calcification confirmed by surgery and pathology,and the contrast-enhanced ultrasonic manifestations of benign and malignant thyroid nodule was compared. Results In 51 malignant nodules,41 nodules with microcalcification,10 nodules with bulky calcification,the proportion of weak enhancement and non-uniform enhancement was82.4% and 88.2%,respectively. In 41 benign nodules,11 nodules with microcalcification,30 nodules with bulky calcification,the proportion of weak enhancement and non-uniform enhancement was 9.8% and 14.6%,respectively. The ratio of microcalcification,weak enhancement and inhomogeneity of malignant nodules were significantly higher than those of benign nodules,there were significant difference(all P <0.05). The peak intensity of malignant thyroid nodules and benign thyroid nodules was(107.21 ±20. 33)d B and(69. 47 ± 16. 34)d B,respectively,there was significant difference(P < 0. 05). However,there was no statistical significance of basic time and the peak time between the benign and malignant thyroid nodules. Conclusion Contrast-enhanced ultrasound has high clinical value and high accuracy in the diagnosis of calcified thyroid nodules.
Objective To explore the clinical value of contrast-enhanced ultrasound in the differential diagnosis of benign and malignant thyroid nodules with calcified lesions. Methods Retrospective analyzed the ultrasonic data of 92 patients with thyroid nodules complicated with calcification confirmed by surgery and pathology,and the contrast-enhanced ultrasonic manifestations of benign and malignant thyroid nodule was compared. Results In 51 malignant nodules,41 nodules with microcalcification,10 nodules with bulky calcification,the proportion of weak enhancement and non-uniform enhancement was82.4% and 88.2%,respectively. In 41 benign nodules,11 nodules with microcalcification,30 nodules with bulky calcification,the proportion of weak enhancement and non-uniform enhancement was 9.8% and 14.6%,respectively. The ratio of microcalcification,weak enhancement and inhomogeneity of malignant nodules were significantly higher than those of benign nodules,there were significant difference(all P <0.05). The peak intensity of malignant thyroid nodules and benign thyroid nodules was(107.21 ±20. 33)d B and(69. 47 ± 16. 34)d B,respectively,there was significant difference(P < 0. 05). However,there was no statistical significance of basic time and the peak time between the benign and malignant thyroid nodules. Conclusion Contrast-enhanced ultrasound has high clinical value and high accuracy in the diagnosis of calcified thyroid nodules.
引文
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[2]伍晓鸣,刘可.超声检查对甲状腺结节良恶性的鉴别价值分析[J].实用癌症杂志,2015,30(11):1741-1743.
[3]钱敏飞,王家东,裘亦辉.甲状腺乳头状癌钙化的临床意义[J].临床耳鼻咽喉头径外科杂志,2011,25(15):673-675.
[4]Ohmori N,Miyakawa M,Ohmori K,et al.Ultrasonographic findings of papollary thyroid carcinoma with Hashimoto’s thyroiditis[J].Intcrn Med,2007,46(9):547-550.
[5]马银华.超声微纯化成像技术对甲状腺钙化灶的检测价值[J].中国医科大学学报,2015,44(10):901-903,908.
[6]杨锦茹,薛姗姗,张华,等.超声造影鉴别良恶性甲状腺实质性结节的应用研究[J].中国现代医学杂志,2016,26(17):59-62.
[7]马文琦,何鑫,周琦,等.超声造影对伴有钙化甲状腺结节的鉴别价值[J].现代肿瘤医学,2015,23(17):2485-2488.
[8]刘伟宗,李泉水,贡雪灏,等.超声造影对伴有钙化甲状腺结节的诊断价值[J].临床和实验医学杂志,2015,14(1):46-48.