目的 探讨超声造影(contrast-enhanced ultrasonography，CEUS)定量分析在甲状腺结节中的应用价值。方法 收集2021年6月—2022年11月就诊于郑州大学附属郑州中心医院的甲状腺结节者60例，予以CEUS检查与微波消融术治疗，以穿刺活检作为金标准，统计CEUS诊断结果，比较不同类型病理组织CEUS定量分析参数[峰值强度(peak intensity，PI)、开始增强时间(arrival time，AT)、曲线下面积(area under the curve，AUC)、峰值时间(time to peak，TTP)]，分析CEUS定量分析的诊断价值以及预后预测价值。结果 以穿刺活检结果作为金标准，阳性26例，阴性34例;CEUS诊断结果为真阳性22例、真阴性29例;CEUS诊断敏感性为84。62％、特异性为85。29％、准确性为85。00％、阳性预测值为81。48％、阴性预测值为87。88％;恶性结节患者PI、AUC低于良性结节患者(P＜0。05);ROC曲线结果，AT、TTP、PI、AUC联合诊断甲状腺恶性结节的AUC为0。811，最佳敏感度为92。31％、特异度为91。18％(P＜0。05);预后不良患者PI、AUC低于预后良好患者(P＜0。05);ROC曲线结果显示，AT、TTP、PI、AUC联合预测预后不良的AUC为0。825，最佳敏感度为75。00％、特异度为83。33％(P＜0。05)。结论 CEUS定量分析对于甲状腺结节良恶性诊断价值较高，并能有效预测预后，可为临床早期干预措施制定提供依据。
Diagnostic significance and prognostic predictive value of quantitative ultrasonography analysis for benign and malignant thyroid nodules
Objective To evaluate the value of quantitative contrast-enhanced ultrasound(CEUS)analysis in the diag-nosis of benign and malignant thyroid nodules and prognosis prediction.Methods A total of 60 thyroid nodule patients ad-mitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2021-November 2022 were selected as research objects,and CEUS examination and microwave ablation were performed.Puncture biopsy was used as the gold standard to analyze the diagnostic results of CEUS.Quantitative CEUS analysis parameters[peak intensity(PI),arrival time(AT),area under curve(AUC),time to peak(TTP)]of different pathological tissues were compared to analyze the diagnostic value and prognostic value of quantitative CEUS analysis.Results The results of puncture biopsy were used as the gold standard,26 cases were positive and 34 cases were negative.The diagnostic results of CEUS were true positive in 22 cases and true negative in 29 cases.The diagnostic sensitivity,specificity,accuracy,positive predictive value and neg-ative predictive value of CEUS were 84.62％,85.29％,85.00％,81.48％and 87.88％respectively.The PI and AUC of malignant nodules were lower than those of benign nodules(P＜0.05).ROC curve results showed that the AUC of AT,TTP,PI and AUC in the combined diagnosis of thyroid malignant nodules was 0.811,the best sensitivity was 92.31％,and the specificity was 91.18％(P＜0.05).PI and AUC in patients with poor prognosis were lower than those in patients with good prognosis(P＜0.05).ROC curve results showed that the AUC of AT,TTP,PI and AUC combined to predict poor prognosis was 0.825,the best sensitivity was 75.00％,and the specificity was 83.33％(P＜0.05).Conclusion Quantitative analysis of CEUS is of high value in the diagnosis of benign and malignant thyroid nodules,and can effectively predict the prognosis,which can provide evidence for the formulation of early intervention measures.
CEUSTIC parameterThyroid noduleDiagnostic valuePrognosisPredictive value
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