| 张亚庆,黄旴宁,范会文,张琼珍,孙章秀,刘小蓝,许珊珊.显微超声造影(SR CEUS)鉴别甲状腺良、恶性结节[J].中国医学影像技术,2026,42(6):829~833 |
| 显微超声造影(SR CEUS)鉴别甲状腺良、恶性结节 |
| Super resolution contrast-enhanced ultrasound (SR CEUS) for differentiating benign and malignant thyroid nodules |
| 投稿时间：2025-11-18 修订日期：2026-05-01 |
| DOI：10.13929/j.issn.1003-3289.2026.06.004 |
| 中文关键词: 甲状腺结节 微循环 显微超声造影 |
| 英文关键词:thyroid nodule microcirculation super resolution contrast-enhanced ultrasound |
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| 中文摘要: |
| 目的 观察显微超声造影(SR CEUS)鉴别甲状腺良、恶性结节的价值。方法 回顾性纳入69例甲状腺结节患者共73个结节,其中恶性41个(恶性组)、良性32个(良性组),均接受常规超声、CDFI、超声造影(CEUS)及SR CEUS检查。分析SR CEUS定量参数,包括最大密度(Max Den)、最小密度(Min Den)、中值密度(Med Den)、平均密度(Mean Den)、密度标准差(Den SD)、血管密度(VD),最大速度(Max Vel)、最小速度(Min Vel)、中值速度(Med Vel)、平均速度(Mean Vel)、速度标准差(Vel SD)、速度方差(Vel Var)、方向方差(Dir Var),以及灌注指数(PI)、血流容积(FWVD)、分形维数(FD)及ROI 面积等。以术后病理结果为金标准,评估各参数鉴别甲状腺良、恶性结节的效能。结果 组间Max Den、Med Den、Mean Den、Den SD及VD,Max Vel、Med Vel、Mean Vel、Vel SD,以及Vel Var、Dir Var、PI、FWVD及FD差异均有统计学意义(P均＜0.05)。Mean Den(OR=0.665,P=0.002)和FD(OR=9.903,P=0.004)均为甲状腺恶性结节的独立预测因素。常规超声、CEUS及SR CEUS诊断甲状腺恶性结节的曲线下面积分别为0.803、0.810及0.904,SR CEUS诊断效能最高,其敏感度为90.24%、特异度为84.38%。结论 SR CEUS鉴别诊断甲状腺良、恶性结节的效能高于常规超声及CEUS。 |
| 英文摘要: |
| Objective To observe the value of super resolution contrast-enhanced ultrasound (SR CEUS) for differentiating benign and malignant thyroid nodules. Methods A total of 73 thyroid nodules in 69 patients were retrospectively enrolled, including 41 malignant nodules (malignant group) and 32 benign ones (benign group). All nodules underwent conventional ultrasound, CDFI, contrast-enhanced ultrasound (CEUS) and SR CEUS examination. Quantitative analysis of SR CEUS parameters, including maximum density (Max Den), minimum density (Min Den), median density (Med Den), mean density (Mean Den), density standard deviation (Den SD), vessel density (VD), maximum velocity (Max Vel), minimum velocity (Min Vel), median velocity (Med Vel), mean velocity (Mean Vel), velocity standard deviation (Vel SD), velocity variance (Vel Var), directional variance (Dir Var), perfusion index (PI), flow-weighted vessel density (FWVD), fractal dimension (FD), and ROI Area were analyzed. Taken postoperative pathological results as the gold standards, the diagnostic performance of each parameter for differentiating benign and malignant thyroid nodules was evaluated. Results Significant differences of Max Den, Med Den, Mean Den, Den SD, VD, Max Vel, Med Vel, Mean Vel, Vel SD, Vel Var, Dir Var, PI, FWVD and FD were found between groups (all P＜0.05). Both Mean Den (OR=0.665, P=0.002) and FD (OR=9.903, P=0.004) were independent predictors of thyroid malignant nodule. The area under the curve of conventional ultrasound, CEUS and SR CEUS for diagnosing thyroid malignant nodule was 0.803, 0.810 and 0.904, respectively. SR CEUS had the highest diagnostic efficacy, with sensitivity of 90.24% and specificity of 84.38%. Conclusion SR CEUS had higher differential diagnostic efficacy than conventional ultrasound and CEUS for differentiating benign and malignant thyroid nodules. |
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