CAJ | 학술논문

目的探讨六氟化硫微泡实时超声造影在甲状腺占位性病变中的应用价值.方法对59例常规超声诊断为甲状腺占位性病变患者的73个病灶再行六氟化硫微泡实时超声造影检查,采用连续超声造影(contrastenhanced ultrasound,CEUS)技术和对比脉冲序列造影成像技术,分析不同占位性病变的CEUS特点.结果 73个病灶均获得满意的动态造影灌注图像.13例超声造影提示15个恶性病灶经术后病理证实为甲状腺乳头状癌,肿瘤直径的大小不同,超声图像呈低或混合回声,边界不清,伴有微小钙化灶,血流分布为Ⅰ级或Ⅲ级.46例超声提示58个良性病灶,血流分布为Ⅱ级或Ⅲ级,二维超声图像表现多样,呈囊性、实性或含液实性团块,边界清.与周边甲状腺组织对比,不同的占位性病变在始增时间、强化程度及强化持续时间上均表现出一定的特点,其中病灶直径≤20 mm的13个甲状腺乳头状癌病灶均为乏血供型;直径>20 mm的2个甲状腺乳头状癌病灶,表现为先于相邻甲状腺实质开始增强及廓清,呈高增强的灌注形式;甲状腺滤泡样腺瘤早于相邻甲状腺实质开始增强及廓清,肿块内造影剂存留时间较长,呈高增强的灌注形式;结节性甲状腺肿增强方式为结节与相邻甲状腺实质同步开始增强,6个病灶造影后表现为结节略早于相邻甲状腺实质开始增强,28个病灶与相邻甲状腺实质同步开始廓清,11个病灶消退早于(开始消退时间≤25 s)相邻甲状腺实质.结论六氟化硫微泡实时超声造影在甲状腺占位性病变的诊断及鉴别诊断中有一定的实用价值,大部分病例可在术前进行定性诊断.
목적 탐토륙불화류미포실시초성조영재갑상선점위성병변중적응용개치.방법 대59례상규초성진단위갑상선점위성병변환자적73개병조재행륙불화류미포실시초성조영검사,채용련속초성조영(contrastenhanced ultrasound,CEUS)기술화대비맥충서렬조영성상기술,분석불동점위성병변적CEUS특점.결과 73개병조균획득만의적동태조영관주도상.13례초성조영제시15개악성병조경술후병리증실위갑상선유두상암,종류직경적대소불동,초성도상정저혹혼합회성,변계불청,반유미소개화조,혈류분포위Ⅰ급혹Ⅲ급.46례초성제시58개량성병조,혈류분포위Ⅱ급혹Ⅲ급,이유초성도상표현다양,정낭성、실성혹함액실성단괴,변계청.여주변갑상선조직대비,불동적점위성병변재시증시간、강화정도급강화지속시간상균표현출일정적특점,기중병조직경≤20 mm적13개갑상선유두상암병조균위핍혈공형;직경>20 mm적2개갑상선유두상암병조,표현위선우상린갑상선실질개시증강급곽청,정고증강적관주형식;갑상선려포양선류조우상린갑상선실질개시증강급곽청,종괴내조영제존류시간교장,정고증강적관주형식;결절성갑상선종증강방식위결절여상린갑상선실질동보개시증강,6개병조조영후표현위결절략조우상린갑상선실질개시증강,28개병조여상린갑상선실질동보개시곽청,11개병조소퇴조우(개시소퇴시간≤25 s)상린갑상선실질.결론 륙불화류미포실시초성조영재갑상선점위성병변적진단급감별진단중유일정적실용개치,대부분병례가재술전진행정성진단.
Objective To explore the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of thyroid occupied lesions with injection of sulphur hexafluoride microbubbles. Methods Fifty nine cases of conventional ultrasonic diagnosis of thyroid lesions in patients with 73 lesions re-sulfur hexafluoride microbubble ultrasound contrast real-time inspection, the use of CEUS and contrast pulse sequencing (CPS). Results Seventy-three lesions were satisfied with the dynamic contrast perfusion imaging. Ultrasound contrast prompted the 15 lesions (13 cases) of malignant lesions by postoperative pathology confirmed papillary thyroid carcinoma, ultrasound images showed a low or mixed echo, boundary ambiguity, accompanied by Microcalcification foci, blood flow distribution Ⅰ rank or grade Ⅲ. Ultrasound prompted 58 lesions (46 cases) of benign lesions, blood flow distribution of grade Ⅱ or Ⅲ, the performance of a variety of two-dimensional ultrasound image, showing cystic, solid or liquid-solid mass, border clearance. Contrast with the surrounding thyroid tissue, lesions ≤ 20 mm in diameter papillary thyroid carcinoma are poor blood supply type; diameter ≥ 20 mm papillary thyroid carcinoma, manifested prior to the beginning of the adjacent thyroid substance to enhance and dissection, showing the form of high-enhanced perfusion; thyroid follicular adenoma as early as the beginning of the adjacent thyroid substance to enhance and dissection, mass retained within the contrast agent longer time, showing the form of high-enhanced perfusion; nodular goiter enhanced for thyroid nodules and adjacent synchronization started to pick up in real terms, after the 6 lesions showed nodular contrast slightly earlier than the adjacent thyroid substance started to pick up, 28 lesions with synchronous real beginning of the adjacent thyroid dissection, 11 lesions of nodular dissipated early on (started receding time ≤ 25 s) adjacent to thyroid substance. Conclusion The real-time CEUS with injecting sulphur hexafluoride microbubbles is valuable in the diagnosis and differential diagnosis of the thyroid occupied lesions.