超声造影在甲状腺结节鉴别诊断及良性结节微波消融治疗中的应用价值

摘要 目的：研究超声造影在甲状腺结节鉴别诊断及良性结节微波消融治疗中的应用价值。方法：选取2015年1月～2018年2月我院收治的甲状腺结节患者100例作为研究对象，所有纳入对象均进行超声造影检查，分析甲状腺结节的超声造影特征，并与病理诊断结果进行对照。此外，将甲状腺良性结节患者以随机抽签法分成超声造影组31例和常规超声组30例。超声造影组微波消融治疗前后均予以超声造影配合，常规超声组微波消融治疗前后均予以常规超声配合。比较两组治疗前后甲状腺结节造影情况以及术后1年结节复发情况。结果：甲状腺恶性结节增强强度为低增强、增强模式为不均匀、无环绕增强占比均高于良性结节（均P＜0.05）。以病理诊断为金标准，超声造影诊断恶性甲状腺结节的灵敏度为92.31%、特异度为78.69%、准确度为84.00%。治疗后超声造影组甲状腺结节最长径、体积均低于常规超声组（均P＜0.05）。超声造影组术后1年结节复发率为0.00%，低于常规超声组的16.67%（P＜0.05）。结论：超声造影应用于甲状腺结节鉴别诊断的价值较高，且结合微波消融治疗良性结节的效果明显，预后理想，值得临床推广应用。

The Application Value of Contrast-enhanced Ultrasound in Differential Diagnosis of Thyroid Nodules and Microwave Ablation of Benign Nodules

ABSTRACT Objective: To study the application value of contrast-enhanced ultrasound in the differential diagnosis of thyroid nodules and microwave ablation of benign nodules. Methods: 100 patients with thyroid nodule who were admitted to our hospital from January 2015 to February 2018 were included as study objects. All the subjects were examined by contrast-enhanced ultrasound, and the features of thyroid nodules were analyzed. The results were compared with pathological diagnosis. In addition, patients with benign thyroid nodules were randomly divided into 31 cases in the contrast-enhanced ultrasound group and 30 cases in the conventional ultrasound group. Contrast-enhanced ultrasound was performed before and after microwave ablation in the contrast-enhanced ultrasound group, and conventional ultrasound was performed before and after microwave ablation in the conventional ultrasound group. Thyroid nodule angiography before and after treatment and nodule recurrence 1 year after operation were compared between the two groups. Results: The enhancement intensity of malignant thyroid nodules was low enhancement, the enhancement pattern was uneven, and the proportion of non-circumferential enhancement were higher than those of benign thyroid nodules(all P<0.05). With pathological diagnosis as the gold standard, the sensitivity of contrast-enhanced ultrasound in the diagnosis of malignant thyroid nodules was 92.31%, the specificity was 78.69%, and the accuracy was 84.00%. After treatment, the longest diameter and volume of thyroid nodules in the contrast-enhanced ultrasound group were lower than those of the conventional ultrasound group (all P<0.05). The recurrence rate of nodules of contrast-enhanced ultrasound group at 1 year after operation was 0.00%, which was lower than 16.67% of conventional ultrasound group (P<0.05). Conclusion: Contrast-enhanced ultrasound is of high value in the differential diagnosis of thyroid nodules, and combined with microwave ablation for the treatment of benign nodules, the prognosis is ideal. It is worthy of clinical application.