| 张波,姜玉新,戴晴,杨萌,高嫔.前瞻性观察甲状腺结节的SonoVue超声造影增强模式[J].中国医学影像技术,2010,26(5):844~847 |
| 前瞻性观察甲状腺结节的SonoVue超声造影增强模式 |
| Prospective observation of contrast-enhanced patterns of thyroid nodules with SonoVue |
| 投稿时间：2009-12-20 修订日期：2010-03-10 |
| DOI： |
| 中文关键词: 甲状腺结节 超声检查 造影剂 |
| 英文关键词:Thyroid nodule Ultrasonography Contrast media |
| 基金项目:863计划资助项目(2006AA02Z4B3)。 |
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| 中文摘要: |
| 目的 探讨甲状腺结节实时灰阶超声造影(CEUS)的增强模式及其对甲状腺结节的鉴别诊断价值。方法 对常规超声检测出的95例患者104个甲状腺结节行CEUS检查,其中良性病灶53个,恶性病灶51个;囊性结节1个,囊实性结节41个,实性结节62个。采用低机械指数灰阶脉冲反相谐波成像,静脉团注SonoVue 1.2 ml,观察时间≥3 min(MI 0.05~0.08)。观察甲状腺良恶性结节的灰阶内部回声结构和CEUS增强模式。结果 注入造影剂后,甲状腺结节呈现均匀增强、不均匀增强、环状增强和无增强4种表现。甲状腺良恶性结节的增强模式总体上有差别(P<0.01)。环状增强提示良性可能性大,敏感度83.02%,特异度94.12%,阳性预测值93.62%,阴性预测值84.21%,准确率88.46%。不均匀增强提示恶性可能大,敏感度88.24%,特异度92.45%,阳性预测值91.84%,阴性预测值89.09%,准确率90.38%。1个囊性结节为良性结节,表现为环状增强。对于囊实性结节和实性结节,环状增强诊断良性结节的阳性预测值分别为93.10%和94.12%,不均匀增强诊断恶性结节的阳性预测值分别为88.89%和92.50%。结论 CEUS在甲状腺结节良恶性鉴别诊断中具有重要应用价值。 |
| 英文摘要: |
| Objective To characterize the enhancement-patterns of thyroid nodules on gray-scale real time contrast-enhanced ultrasound (CEUS), and to evaluate the potential value of CEUS for the differential diagnosis of thyroid nodules. Methods One hundred and four thyroid nodules in 95 patients detected with B-mode ultrasonography (51 malignant and 53 benign) were examined with CEUS prospectively. One cystic nodule, 41 mixed nodules and 62 solid nodules were included. After intravenous bolus injection of 1.2 ml of SonoVue, lesions were scanned at least 3 minutes at low MI (0.05－0.08). Combined with the echotexture of the nodules, the enhancement patterns were evaluated. Results Following administration of SonoVue, four enhancement patterns (homogeneous, heterogeneous, ring and absent enhancement) were observed. There was significant difference in enhancement patterns between benign and malignant nodules (P<0.01). Ring enhancement correlated highly with benign nodule (sensitivity 83.02%, specificity 94.12%, positive predictive value 93.62%, negative predictive value 84.21% and accuracy 88.46%). Heterogeneous enhancement correlated highly with malignant diagnosis (sensitivity 88.24%, specificity 92.45%, positive predictive value 91.84%, negative predictive value 89.09% and accuracy 90.38%). In both mixed and solid nodules, ring enhancement was highly predictive of benign finding (the positive predictive value were 93.10% and 94.12%, respectively),whereas heterogeneous enhancement was highly predictive of malignant finding (the positive predictive value were 88.89% and 92.50%,respectively). Conclusion CEUS is a useful tool to differentiate thyroid nodule. |
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