王莹, 张岱, 杨凡, 张晟. 超微血流显像与超声造影对甲状腺实性结节的诊断价值[J]. 中国肿瘤临床, 2021, 48(14): 711-715. DOI: 10.3969/j.issn.1000-8179.2021.14.158
引用本文: 王莹, 张岱, 杨凡, 张晟. 超微血流显像与超声造影对甲状腺实性结节的诊断价值[J]. 中国肿瘤临床, 2021, 48(14): 711-715. DOI: 10.3969/j.issn.1000-8179.2021.14.158
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Ying Wang, Dai Zhang, Fan Yang, Sheng Zhang. The diagnostic value of superb micro-vacular imaging and contrast-enhancedultrasound in solid thyroid nodules[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2021, 48(14): 711-715. DOI: 10.3969/j.issn.1000-8179.2021.14.158
Citation: Ying Wang, Dai Zhang, Fan Yang, Sheng Zhang. The diagnostic value of superb micro-vacular imaging and contrast-enhancedultrasound in solid thyroid nodules[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2021, 48(14): 711-715. DOI: 10.3969/j.issn.1000-8179.2021.14.158
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超微血流显像与超声造影对甲状腺实性结节的诊断价值

The diagnostic value of superb micro-vacular imaging and contrast-enhancedultrasound in solid thyroid nodules

    摘要
  • 摘要:
      目的  比较超微血流显像技术（superb micro-vacular imaging，SMI）与超声造影（contrast-enhanced ultrasound，CEUS）对甲状腺实性结节鉴别诊断的价值。
      方法  收集2018年1月至2020年12月天津医科大学肿瘤医院诊断为甲状腺实性结节患者384例，共525枚结节，其中男性99例，女性285例，年龄18～81岁，平均年龄（46.63±18.56）岁。525枚结节分别应用SMI及CEUS两种检查方法，以术后组织学病理结果为金标准，比较二者的诊断效能。SMI模式下分析结节的血流分级、血流分布模式分型及穿支血管；CEUS模式下，分析结节的增强模式。
      结果  525枚结节中，恶性354枚，良性171枚。应用SMI诊断，84.21%（144枚）的甲状腺良性结节及86.72%（307枚）的甲状腺恶性结节Adler血流分级为2～3级；分别有27.49%（47枚）和47.37%（81枚）的良性结节血流分布模式分型为Ⅲ型及Ⅳ型，86.44%的恶性结节血流分布模式分型为Ⅱ型。恶性结节的穿支血管检出率达86.72%（307枚）。应用CEUS诊断，分别有47.95%（82枚）及33.33%（57枚）的良性结节表现为高增强及等增强；88.98%（315枚）的恶性结节表现为低增强。应用SMI的血流分布模式分型结合穿支血管检出分析甲状腺实性结节的诊断效能，其灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为86.44%、74.85%、82.67%、87.68%、72.73%，CEUS分别为88.98%、81.29%、86.48%、90.78%、78.09%，二者比较差异均无统计学意义（均P>0.05）。
      结论  SMI的血流分布模式分型结合穿支血管对甲状腺实性结节的诊断效能与CEUS相仿，具有较高的临床价值，为超声医师提供了新的诊断方法。

     

    Abstract:
      Objective  To compare the clinical value of superb micro-vascular imaging (SMI) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of solid thyroid nodules.
      Methods  A total of 384 patients with 525 lesions of solid thyroid nodules from Tianjin Medical University Cancer Institute and Hospital were enrolled in this study from January 2018 to December 2020. The subjects included 99 males and 285 females, aged 18 to 81 years old. The average age was (46.63±18.56) years. These nodules were examined using both SMI and CEUS. The diagnoses of SMI and CEUS were contrasted with the post-operative pathology. The blood flow classification, distribution pattern, and perforating vessels were analyzed using SMI, while the enhanced patterns were simultaneously evaluated by CEUS.
      Results  Among 525 lesions, 354 were malignant and 171 were benign. By SMI, 84.21% benign nodules and 86.72% malignant nodules were classified as Adler grade 2 or 3; 27.49% and 47.37% benign nodules were diagnosed as type Ⅲ and Ⅳ according to blood flow distribution pattern, while 86.44% malignant nodules were type Ⅱ. The detection rate of perforating vessel flow in malignant nodules was 86.72%. By CEUS, 47.95% and 33.33% of benign nodules were “equal enhancement” and “high enhancement” and 88.98% of malignant nodules were “low enhancement”. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value classification of blood flow distribution pattern combined with perforating vessel flow of SMI were 86.44%, 74.85%, 82.67%, 87.68%, and 72.73%, respectively; the values by CEUS were 88.98%, 81.29%, 86.48%, 90.78%, and 78.09%, respectively. There was no statistical difference in diagnostic efficacy between CEUS and classification of blood flow distribution pattern combined with perforating vessels flow of SMI (P>0.05).
      Conclusions  The diagnostic value of SMI with blood flow distribution pattern and perforating vessels is similar to that of CEUS for solid thyroid nodules. SMI can, thus, be considered a new method of ultra sound diagnosis of solid thyroid nodules.

     

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