[1]吴 明,张欣玉△,石 锋,等.超声造影联合CT检查对甲状腺良恶性结节的鉴别诊断研究[J].陕西医学杂志,2020,49(3):333-336.
　WU Ming,ZHANG Xinyu,SHI Feng,et al.Differential diagnosis of benign and malignant thyroid nodules by contrast-enhanced ultrasound combined with CT[J].,2020,49(3):333-336.
点击复制

超声造影联合CT检查对甲状腺良恶性结节的鉴别诊断研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年3期
页码:
333-336
栏目:
临床研究
出版日期:
2020-03-05

文章信息/Info

Title:
Differential diagnosis of benign and malignant thyroid nodules by contrast-enhanced ultrasound combined with CT
文章编号:
DOI:〖HT5K〗10.3969/j.issn.10007377.2020.03.018
作者:
吴 明; 张欣玉△; 石 锋; 舒 松
湖北省天门市第一人民医院(天门 431700)
Author(s):
WU Ming; ZHANG Xinyu; SHI Feng; et al.
First People's Hospital of Tianmen City,Hubei Province(Tianmen 431700)
关键词:
CT;  超声造影;  甲状腺结节;  癌;  鉴别诊断
Keywords:
CT;  Contrast-enhanced ultrasound;  Thyroid nodules;  Cancer;  Differential diagnosis
分类号:
R445.3
文献标志码:
A
摘要:
目的:分析超声造影及CT检查在甲状腺良恶性结节临床鉴别诊断中的应用价值。方法:选择甲状腺结节患者105例,均进行超声造影及CT检查,将病理检查结果作为“金标准”,对单独CT检查、超声造影检查、CT联合超声造影检查准确性、特异性、敏感性差异进行分析。结果:105例患者病理检查结果显示,甲状腺良性结节患者共81例(77.14%),其中甲状腺瘤18例(17.14%),结节性甲状腺肿54例(51.43%),桥本氏甲状腺炎9例(8.57%); 甲状腺恶性结节共24例(22.86%),其中乳头状癌15例(14.29%),髓样癌3例(2.86%),滤泡状癌6例(5.71%); 超声造影联合CT诊断准确性、特异性及敏感性均显著高于单独CT检查与单独超声造影检查(P<0.05)。结论:甲状腺良恶性结节临床鉴别诊断中CT与超声造影联合使用可有效提高诊断准确性,且联合诊断方式对患者无创伤性,检查安全性较高,患者耐受性较好,对降低误诊与漏诊情况的发生、提高诊断效率均具有重要意义。
Abstract:
Objective: To analyze the value of contrast-enhanced ultrasound and CT in the differential diagnosis of benign and malignant thyroid nodules. Methods: 105 patients with thyroid nodules were enrolled in the study. All patients underwent contrast-enhanced ultrasound and CT examinations after admission. The results of pathological examinations were regarded as the “gold standard”. The differences in accuracy,specificity and sensitivity of CT examination,contrast-enhanced ultrasound and CT with combined contrast-enhanced ultrasound were analyzed. Results: There were 81 patients with benign thyroid nodules(77.14%),including 18 cases of thyroid tumors(17.14%),54 cases of nodular goiter(51.43%),and 9 cases of Hashimoto's thyroiditis(8.57%). There were 24 patients with thyroid malignant nodules(22.86%),including 15 cases of papillary carcinoma(14.29%),3 cases of medullary carcinoma(2.86%),and 6 cases of follicular carcinoma(5.71%). The accuracy,specificity and sensitivity of contrast-enhanced ultrasound combined with CT were significantly higher than those of CT and contrast-enhanced ultrasound alone(P<0.05). Conclusion: The combination of CT and contrast-enhanced ultrasound in the differential diagnosis of benign and malignant thyroid nodules can effectively improve the diagnostic accuracy. The combined diagnosis method is non-invasive for patients,has higher inspection safety and better patient tolerance. It is of great significance to reduce the occurrence of misdiagnosis and missed diagnosis and improve the diagnosis efficiency.

参考文献/References:

[1] 马春旭,袁卫红,赵艳花,等.99Tcm-MIBI显像联合超声鉴别诊断甲状腺结节良恶性的临床研究[J].中华核医学与分子影像杂志,2016,36(4):326-329.
[2] 中华医学会内分泌学分会,中华医学会外科学分会内分泌学组,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南[J].中华核医学与分子影像杂志,2013,33(2):96-115.
[3] Pacini F,Burroni L,Ciuoli C,et al.Management of thyroid nodules:a clinicopathological,evidence-based approach[J].Eur J Nucl Med Mol Imaging,2014,31(10):1443-1449.
[4] 黄 雪,夏红梅,谭开彬,等.超声及CT诊断甲状腺良恶性结节的临床研究[J].中国CT和MRI杂志,2017,15(2):39-41.
[5] 李进叶,宋歌声,宋吉清,等.宝石能谱CT与常规超声对甲状腺结节良恶性诊断价值的对照分析[J].山东大学学报:医学版,2016,54(3):81-86.
[6] 刘尼军,周 欣,李江涛.结节性甲状腺肿多层螺旋CT诊断及鉴别诊断[J].陕西医学杂志,2018,47(5):85-87,90.
[7] Nicholson KJ,Yip L.An update on the status of molecular testing for the indeterminate thyroid nodule and risk stratification of differentiated thyroid cancer[J].Current Opinion in Oncology,2018,30(1):8.
[8] 韩志江,舒艳艳,雷志锴,等.高增强征象在超声、CT及二者联合诊断甲状腺良、恶性结节中的价值[J].中华内分泌外科杂志,2017,11(1):15-19.
[9] Molinaro E,Elisei R,Romei C.Clinical impact of molecular techniques for the presurgical diagnosis of differentiated thyroid cancer diagnosis[J].Expert Review of Endocrinology & Metabolism,2017,519(2):1-8.
[10] 陶 菁.超声造影技术在甲状腺良恶性结节鉴别中的应用[J].医学综述,2018,24(1):170-174.
[11] 李 龙,吕 镔,王双龙,等.超声引导细针穿刺活检对青少年和青年甲状腺结节的诊断价值[J].陕西医学杂志,2018,47(12):49-50,54.
[12] Tarasova VD,Tuttle RM.Current management of low risk differentiated thyroid cancer and papillary microcarcinoma[J].Clinical Oncology,2017,29(5):290-297.
[13] Zhang B,Jiang YX,Liu JB,et al.Utility of contrast enhanced ultrasound for evaluation of thyroid nodules[J].Thyroid,2010,20(1):51-57.
[14] 盖曰秀.超声检查在甲状腺结节不同分型钙化诊断中的应用评价研究[J].中国医学装备,2016,13(10):55-58.
[15] Lacout A,Chamorey E,Thariat J,et al.Insight into differentiated thyroid cancer gross pathological specimen shrinkage and its influence on TNM staging[J].European Thyroid Journal,2017,6(6):315-320.
[16] 王育红,黄 云,张 炎,等.甲状腺结节数对钙化甲状腺病变良恶性的鉴别价值[J].现代生物医学进展,2015,15(11):2073-2075.
[17] 陈 瑛,于明安,闫 娟,等.超声造影对不同大小甲状腺结节良恶性诊断价值[J].陕西医学杂志,2017,46(4):446-447.
[18] 梁杏芬,杨 璞,黎天明,等.超声弹性成像应变率比值法联合"萤火虫"成像技术诊断甲状腺良恶性结节的价值[J].临床超声医学杂志,2018(3):204-206.
[19] 魏 云,周 静,胡文江.高频超声在甲状腺良恶性结节鉴别诊断中的应用价值[J].影像研究与医学应用,2018,2(9):190-191.
[20] 施燕芸,李念芬,张 文,等.超声造影成像特征及定量参数对甲状腺良恶性结节的诊断价值[J].临床和实验医学杂志,2019,18(2):93-97.
[21] 于 璐,尚 敬,阚全娥.桥本甲状腺炎患者甲状腺良恶性结节超声特征及影响因素分析[J].中华实用诊断与治疗杂志,2018,32(5):61-63.
[22] 陈丹丹,王 婷.CT环状钙化在甲状腺良恶性结节诊断和鉴别诊断中的价值[J].河北医学,2018,263(5):49-51.

相似文献/References:

[1]王双龙,吕 镔△,李 龙,等.超声造影参数成像在甲状腺微小乳头状癌鉴别诊断中的应用价值*[J].陕西医学杂志,2020,49(5):599.
　WANG Shuanglong,LV Bin,LI Long,et al.The value of parametric imaging of contrast-enhanced ultrasound in differential diagnosis of papillary thyroidmicrocarcinoma[J].,2020,49(3):599.
[2]周 璇,刘海静,白 洁△.经腹超声造影鉴别诊断子宫内膜病变价值及与微血管密度关系探讨*[J].陕西医学杂志,2020,49(8):960.[doi:DOI:10.3969/j.issn.1000-7377.2020.08.012]
　ZHOU Xuan,LIU Haijing,BAI Jie..Value of transabdominal contrast-enhanced ultrasonography in the differential diagnosis of endometrial lesions and its relationship with microvessel density[J].,2020,49(3):960.[doi:DOI:10.3969/j.issn.1000-7377.2020.08.012]
[3]李春艳,李忠原△.基于超声组学的甲状腺结节良恶性预测关键技术研究[J].陕西医学杂志,2020,49(9):1134.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.020]
　LI Chunyan,LI Zhongyuan..Study on the key technique of benign and malignant thyroid nodule prediction based on ultrasomics[J].,2020,49(3):1134.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.020]
[4]芦 霄,秦海英,张 悦,等.超声引导下微创消融治疗子宫腺肌症疗效评估[J].陕西医学杂志,2021,50(1):32.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.008]
　LU Xiao,QIN Haiying,ZHANG Yue,et al.Evaluation of ultrasound-guided minimally invasive ablation of adenomyosis[J].,2021,50(3):32.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.008]
[5]窦 飞,王国清,宋东虎,等.CT评估慢性阻塞性肺疾病肺功能临床研究进展[J].陕西医学杂志,2023,52(7):942.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.038]
　DOU Fei,WANG Guoqing,SONG Donghu,et al.Clinical research progress in CT evaluation of pulmonary function in chronic obstructive pulmonary disease[J].,2023,52(3):942.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.038]
[6]周 琴,黄丽琼,胡丽蓉,等.超声造影参数评估子宫内膜癌患者预后价值研究[J].陕西医学杂志,2024,(8):1055.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.010]
　ZHOU Qin,HUANG Liqiong,HU Lirong,et al.Value of contrast-enhanced ultrasound parameters in evaluating prognosis of patients with endometrial carcinoma[J].,2024,(3):1055.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.010]

更新日期/Last Update: 2020-03-25