| 超声造影定量分析对鉴别甲状腺微钙化结节性质的研究 |
| 投稿时间：2017-04-12 修订日期：2017-04-25 点此下载全文 |
| 引用本文：姜云雯,朱凌源,彭敏霞,颜树宏,赵臣银,郑笑娟.超声造影定量分析对鉴别甲状腺微钙化结节性质的研究[J].医学研究杂志,2018,47(1):99-102 |
| DOI：
10.11969/j.issn.1673-548X.2018.01.024 |
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| 基金项目:浙江省科技厅公益性技术应用研究计划基金资助项目（2012C23059）；浙江省医学会基金资助项目（2015ZYC-A88）；舟山市卫计局基金资助项目（2014T01）；2009年舟山市科技局基金资助项目（043）；舟山市科技局基金资助项目（2016C13042） |
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| 中文摘要:目的 评价超声造影定量分析参数对甲状腺微钙化结节不同区域血流灌注的意义及其对该类结节性质的鉴别诊断价值。方法 对83例伴微钙化的甲状腺结节患者行术前超声造影检查，绘制时间-强度曲线（time-intensity curve，TIC）获得结节中心、结节边缘及周围正常甲状腺组织的定量参数（峰值强度Peak、达峰时间TP、曲线下面积AUC、平均渡越时间MTT）。比较良恶性结节不同区域超声造影定量参数的差异，并应用ROC曲线进行分析。结果 83例伴微钙化的结节，恶性49例，良性34例。恶性组中，结节中心Peak、AUC小于结节边缘及周围正常甲状腺组织，结节边缘Peak、AUC小于周围正常甲状腺组织，差异均有统计学意义（P<0.05）；良性组3个区域定量参数比较，差异均无统计学意义（P>0.05）。恶性组与良性组定量参数相比，中心及边缘Peak均降低，中心及边缘AUC均减小，差异均有统计学意义（P<0.05），TP及MTT差异均无统计学意义（P>0.05）；绘制ROC曲线比较发现感兴趣区（region of interest，ROI）位于结节中心的诊断效能大于其位于结节边缘，差异有统计学意义（P<0.05）；通过ROC曲线确定良恶性结节的临界诊断点分别为结节中心Peak 20.3%、结节中心AUC 1259.8% S。中心Peak及AUC对伴微钙化的甲状腺恶性结节诊断敏感度分别为85.71%、85.71%，特异性分别为97.06%、82.35%。结论 超声造影定量分析对鉴别甲状腺微钙化结节的性质具有一定价值。 |
| 中文关键词:超声造影 微钙化 甲状腺结节 时间-强度曲线 |
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| Quantitative Analysis of Thyroid Nodules with Microcalcification by Contrast-enhanced Ultrasonography |
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| Abstract:Objective To compare the perfusion difference between the different regions of microcalcified thyroid nodules, and to evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of these nodules. Methods Eighty three patients with microcalcified thyroid nodules were examined by CEUS before operation. The time-intensity curves (TIC) of CEUS were plotted in the nodule center, the nodular edge and the normal thyroid tissue, in order to collect the perfusion index including the peak, time to peak (TP), area under the curve (AUC) and mean transit time (MTT). We compared the difference between the different perfusional regions in benign and malignant thyroid nodule with microcalcification. Then we dreawn the ROC to analyze. Results In 83 microcalcified thyroid nodules,there were 49 malignant thyroid nodules,and 34 benign thyroid nodules.In the malignant group, peak shows gradually increased from the nodular center to the nodular edge and normal thyroid tissue. The differences were statistically significant(P<0.05). However, in the benign tumor group, there was no obvious statistic difference in the quantitative parameters(P>0.05). The nodules center or nodules edge Peak and AUC of CEUS in the malignant group were all less than that in the benign group. The differences of the Peak and AUC in the malignant and benign group were statistically significant (P<0.05), while the differences of PT and MTT were not significant in these two groups(P>0.05). Compared with the ROC curve, it was found that the region of interest (ROI) located at the center of the nodule was greater than that at the edge of the nodule. The differences were statistically significant(P<0.05).The cut-off value in diagnosis of benign and malignant thyroid nodules with microcalcification assessed by ROC curve were the nodule center Peak 20.3%, the nodule center AUC 1259.8%S, the sensitivity were 85.71%, 85.71% and the specificity were 97.06%, 82.35%, respectively. Conclusion CEUS is helpful to identify the benign and malignant thyroid nodules with microcalcification. |
| keywords:Contrast-enhanced ultrasonography Microcalcification Thyroid nodules Time-intensity curves |
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