甲状腺良、恶性结节的超声造影特点及临床价值

发布时间：2018-06-10 18:44

本文选题：超声造影 + 甲状腺结节　；参考：《辽宁医学院》2014年硕士论文

【摘要】：目的探讨甲状腺结节的良性和恶性的超声造影特点及超声造影在甲状腺结节良性、恶性鉴别诊断中的临床价值。方法选取我院收治的60例患者（2012.12－2013.5），给予常规的超声检测和造影检测，检测甲状腺结节血流灌注的分布类型、强化程度、分析时间-强度曲线，与病理结果或穿刺活检结果相对比，，评价造影前和造影后超声诊断的准确程度。结果 1、95例结节活检或手术病理证实，40个良性结节和55个恶性结节。常规超声诊断结果的敏感性占总体的72.7%，特异性占总体的87.5%，准确程度为83%。 2、超声造影诊断结果为：甲状腺结节良恶性的敏感性占总体的87.2%，特异性占总体的97.5%，准确程度为91.6%。 3、与病理诊断的结果相对比，常规超声检测与超声造影检测结果示：甲状腺结节良性、恶性方面差异有统计学意义（P0.05）。 4、超声造影的结果提示，良性病变主要是环状强化（30/40）及和高增强（29/40）；恶性病变造影主要是不均匀性的强化（50/55）和低增强（38/55）。 5、超声造影结果提示：良性结节达峰时间高于恶性结节，恶性结节的曲线尖度和曲线下面积均高于良性结节，造影后的良性与恶性结节对比，差异具有统计学意义（P0.05）。结论 1、常规超声是诊断甲状腺结节的首选方法，是一种安全、便捷、有效、重复性高的无创检查手段，但在诊断甲状腺结节良、恶性方面仍存在一定的困难。 2、超声造影检测技术在结节定性诊断中的灵敏度、特异度、准确度均高于常规的超声检测，超声造影定性诊断能力优于常规超声。 3、超声造影对甲状腺结节的诊断通过造影后灌注分布类型、强化程度及造影时间-强度曲线进行分析，为鉴别甲状腺结节的定性提供了诊断依据，在结节定性诊断中具有一定的优势。
[Abstract]:Objective to investigate the characteristics of benign and malignant contrast-enhanced ultrasonography in thyroid nodules. Methods 60 cases of malignant nodule were selected in our hospital from February 12 to March 2013.The distribution type, enhancement degree and time-intensity curve of the blood perfusion of thyroid nodule were detected by conventional ultrasonography and contrast examination. Compared with pathological results and biopsy results, the accuracy of ultrasound diagnosis before and after angiography was evaluated. Results 95 cases of nodules were confirmed by biopsy or surgery, 40 benign nodules and 55 malignant nodules were confirmed. The sensitivity of conventional ultrasound diagnosis is 72.7%, the specificity is 87.5%, and the accuracy is 83.2%. The diagnostic results of contrast-enhanced ultrasonography are as follows: the sensitivity of benign and malignant thyroid nodules is 87.2%, the specificity is 97.5% of the total, and the degree of accuracy is 97.5%. It was 91.6. 3, compared with the results of pathological diagnosis, The results of conventional ultrasonography and contrast-enhanced ultrasonography showed that there were significant differences in benign and malignant thyroid nodules. Benign lesions are mainly circular enhancement (30 / 40) and high enhancement (29 / 40); malignant lesions are mainly heterogeneous enhancement (50 / 55) and low contrast enhancement (38 / 55.5). The results of contrast-enhanced ultrasonography indicate that the peak time of benign nodules is higher than that of malignant nodules. The curve acuity and area under the curve of malignant nodules are higher than that of benign nodules. The difference between benign and malignant nodules after contrast is statistically significant (P 0.05). Conclusion 1. Conventional ultrasound is the first choice for the diagnosis of thyroid nodules, which is safe and convenient. Effective and highly reproducible noninvasive examination methods, but there are still some difficulties in the diagnosis of benign and malignant thyroid nodules. 2. The sensitivity and specificity of contrast-enhanced ultrasonography in the qualitative diagnosis of nodules. The accuracy of ultrasonography was higher than that of conventional ultrasonography, and the diagnostic ability of contrast-enhanced ultrasound was superior to that of conventional ultrasound. 3. The distribution of perfusion, enhancement degree and time-intensity curve were analyzed in the diagnosis of thyroid nodules by contrast-enhanced ultrasonography. It provides a diagnostic basis for the qualitative diagnosis of thyroid nodules and has some advantages in the qualitative diagnosis of thyroid nodules.
【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1

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