The Value of Peripheral Enhancement Pattern for Diagnosing Thyroid Cancer Using Contrast-Enhanced Ultrasound
The Value of Peripheral Enhancement Pattern for Diagnosing Thyroid Cancer Using Contrast-Enhanced Ultrasound
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外周增强模式对超声造影诊断甲状腺癌的价值
DOI：
10.1155/2018/1625958
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发表时间：
2018-01-01
影响因子：
2.8
通讯作者：
Tang, Jie
中科院分区：
文献类型：
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作者：
Zhang, Yan;Zhang, Ming-bo;Tang, Jie
背景对比增强超声(CEUS)扫描可以发现甲状腺肿瘤与周围组织之间的差异。然而，结节内的强化模式不足以诊断甲状腺癌。结节的周边强化模式可提供有用的诊断信息。本研究的目的是探讨CEUS扫描甲状腺结节时周边强化模式的诊断准确性。材料与方法收集经手术证实的120个经CEUS检查并经手术病理证实的周围环结节。评价这些结节的内部和外周CEUS增强模式，并与常规超声诊断价值进行比较。分析结节周围环类型与结节大小的关系。结果良性结节78例，恶性结节42例。外周不规则环对恶性肿瘤的检出效果较好。它通过结合内部增强模式(诊断敏感性为97.6%，特异性为98.7%，准确性为98.3%)提高了CEUS的诊断性能，并增加了常规超声的价值(95.2%，70.5%和79.2%)。有规则高强化环的结节大小(2.34 ± 1.33 cm)大于其他3种类型的周边环(P<；0.05)。结论外周环在CEUS上的表现对甲状腺癌的诊断具有重要意义，结合内部强化模式可进一步提高诊断的准确性，避免不必要的活检。
Background Contrast-enhanced ultrasound (CEUS) scanning can detect differences between thyroid tumors and surrounding tissues. However, enhancement patterns within nodules are insufficient for the diagnosis of thyroid carcinomas. The peripheral enhancement patterns of nodules may provide useful diagnostic information. The objective of this study was to investigate the diagnostic accuracy of the peripheral enhancement patterns during CEUS scanning of thyroid nodules. Material and Methods 120 nodules with peripheral rings during CEUS and definite pathology confirmed by surgery were included in this study. The internal and peripheral CEUS enhancement patterns of these nodules were assessed, and the diagnostic value of CEUS was compared with the conventional ultrasound. The relationship of types of peripheral rings and sizes of nodules was analyzed, respectively. Results There were 78 benign and 42 malignant nodules. Peripheral irregular ring performs well in detecting malignancy. It improves the diagnostic performance of CEUS by combining with internal enhancement patterns (diagnostic sensitivity of 97.6%, specificity of 98.7%, and accuracy of 98.3%) and adds value to conventional ultrasound (95.2%, 70.5%, and 79.2%). The sizes of the nodules with regular high-enhanced rings (2.34 ± 1.33 cm) were larger than the other three types of peripheral rings (P < 0.05). Conclusions Features of peripheral ring on CEUS are important for the diagnosis of thyroid cancer; they can further contribute to the accuracy combining with the internal enhancement pattern, which could avoid the unnecessary biopsy.