| 陈蕾,陈路增,刘晶华,梁振威,王彬.超声造影及BRAF基因突变在甲状腺乳头状癌被膜外侵犯诊断中的应用价值[J].中国医学影像技术,2020,36(1): |
| 超声造影及BRAF基因突变在甲状腺乳头状癌被膜外侵犯诊断中的应用价值 |
| Value of contrast-enhanced ultrasound and BRAF mutation in the diagnosis of extracapsular extension in papillary thyroid carcinoma |
| 投稿时间：2019-07-31 修订日期：2020-01-10 |
| DOI： |
| 中文关键词: 超声造影，BRAF基因突变，甲状腺乳头状癌，被膜外侵犯 |
| 英文关键词:Contrast enhanced ultrasound BRAF mutation Papillary thyroid carcinoma Extracapsular extension |
| 基金项目:北京大学第一医院青年临床研究专项 |
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| 中文摘要: |
| 目的：探讨超声造影（CEUS）及BRAF基因突变在甲状腺乳头状癌（PTC）被膜外侵犯术前诊断中的价值。
方法：入组119名患者共129个PTC病灶，其中25个经术后病理证实存在甲状腺被膜外侵犯。记录传统超声（US）及CEUS模式下PTC与被膜接触范围、是否出现被膜中断现象，以及患者BRAF基因突变检测结果。计算上述特征单独及联合诊断PTC被膜外侵犯的效能。
结果：被膜外侵犯组BRAF基因突变阳性率、US及CEUS被膜接触范围及被膜中断率均显著高于无侵犯组（P<0.05）。接触范围中，US及CEUS均以?25%为界值诊断被膜外侵犯准确度最高。在各超声特征单独及联合BRAF基因突变用于诊断时，CEUS准确度均高于US，CEUS联合BRAF准确度88.38%。
结论：PTC被膜外侵犯临床、超声特征包括：BRAF基因突变阳性、US及CEUS显示结节与被膜接触?25%及被膜中断。CEUS诊断准确度高于US。CEUS联合BRAF基因突变在术前诊断PTC被膜外侵犯中具有重要意义。 |
| 英文摘要: |
| Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) and BRAF mutation in the pre-operative diagnosis of extracapsular extension in papillary thyroid carcinoma (PTC).
Methods: A total of 129 PTCs in 119 patients were enrolled retrospectively, including 25 cases with extracapsular extension confirmed by surgical pathology. Both the range of contact between PTC and thyroid capsule and the presence of discontinued capsule in US and CEUS were recorded, as was the BRAF mutation examination result. The diagnostic performance of these above features in the diagnosis of extracapsular extension in PTC as well as the overall diagnostic performance of their combination were calculated.
Results: Significant differences were found in BRAF mutation, range of capsule contact and the presence of discontinued capsule in US and CEUS (all P value< 0.05). In different ranges of contact, the threshold of ?25% demonstrated the highest diagnostic accuracy in both US and CEUS. CEUS had higher accuracy than US in the diagnosis of extracapsular extension in PTC based on single ultrasonic feature as well as the combination of ultrasonic features and BRAF mutation. The accuracy of CEUS combined with BRAF was 88.38%.
Conclusions: The clinical and ultrasonic characteristics of extracapsular extension in PTC include BRAF mutation, ?25% range of contact between PTC and thyroid capsule and the presence of discontinued capsule in US and CEUS. CEUS has higher accuracy than US and the combination of BRAF mutation and CEUS has important clinical significance in the preoperative diagnosis of PTC extracapsular extension. |
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