本文選題：超聲造影 + 甲狀腺結節(jié)��； 參考：《遼寧醫(yī)學院》2014年碩士論文

【摘要】：目的 探討甲狀腺結節(jié)的良性和惡性的超聲造影特點及超聲造影在甲狀腺結節(jié)良性、惡性鑒別診斷中的臨床價值。 方法 選取我院收治的60例患者（2012.12－2013.5），給予常規(guī)的超聲檢測和造影檢測，檢測甲狀腺結節(jié)血流灌注的分布類型、強化程度、分析時間-強度曲線，與病理結果或穿刺活檢結果相對比，，評價造影前和造影后超聲診斷的準確程度。 結果 1、95例結節(jié)活檢或手術病理證實，40個良性結節(jié)和55個惡性結節(jié)。常規(guī)超聲診斷結果的敏感性占總體的72.7%，特異性占總體的87.5%，準確程度為83%。 2、超聲造影診斷結果為：甲狀腺結節(jié)良惡性的敏感性占總體的87.2%，特異性占總體的97.5%，準確程度為91.6%。 3、與病理診斷的結果相對比，常規(guī)超聲檢測與超聲造影檢測結果示：甲狀腺結節(jié)良性、惡性方面差異有統(tǒng)計學意義（P0.05）。 4、超聲造影的結果提示，良性病變主要是環(huán)狀強化（30/40）及和高增強（29/40）；惡性病變造影主要是不均勻性的強化（50/55）和低增強（38/55）。 5、超聲造影結果提示：良性結節(jié)達峰時間高于惡性結節(jié)，惡性結節(jié)的曲線尖度和曲線下面積均高于良性結節(jié)，造影后的良性與惡性結節(jié)對比，差異具有統(tǒng)計學意義（P0.05）。 結論 1、常規(guī)超聲是診斷甲狀腺結節(jié)的首選方法，是一種安全、便捷、有效、重復性高的無創(chuàng)檢查手段，但在診斷甲狀腺結節(jié)良、惡性方面仍存在一定的困難。 2、超聲造影檢測技術在結節(jié)定性診斷中的靈敏度、特異度、準確度均高于常規(guī)的超聲檢測，超聲造影定性診斷能力優(yōu)于常規(guī)超聲。 3、超聲造影對甲狀腺結節(jié)的診斷通過造影后灌注分布類型、強化程度及造影時間-強度曲線進行分析，為鑒別甲狀腺結節(jié)的定性提供了診斷依據(jù)，在結節(jié)定性診斷中具有一定的優(yōu)勢。
[Abstract]:Objective to investigate the characteristics of benign and malignant contrast-enhanced ultrasonography in thyroid nodules. Methods 60 cases of malignant nodule were selected in our hospital from February 12 to March 2013.The distribution type, enhancement degree and time-intensity curve of the blood perfusion of thyroid nodule were detected by conventional ultrasonography and contrast examination. Compared with pathological results and biopsy results, the accuracy of ultrasound diagnosis before and after angiography was evaluated. Results 95 cases of nodules were confirmed by biopsy or surgery, 40 benign nodules and 55 malignant nodules were confirmed. The sensitivity of conventional ultrasound diagnosis is 72.7%, the specificity is 87.5%, and the accuracy is 83.2%. The diagnostic results of contrast-enhanced ultrasonography are as follows: the sensitivity of benign and malignant thyroid nodules is 87.2%, the specificity is 97.5% of the total, and the degree of accuracy is 97.5%. It was 91.6. 3, compared with the results of pathological diagnosis, The results of conventional ultrasonography and contrast-enhanced ultrasonography showed that there were significant differences in benign and malignant thyroid nodules. Benign lesions are mainly circular enhancement (30 / 40) and high enhancement (29 / 40); malignant lesions are mainly heterogeneous enhancement (50 / 55) and low contrast enhancement (38 / 55.5). The results of contrast-enhanced ultrasonography indicate that the peak time of benign nodules is higher than that of malignant nodules. The curve acuity and area under the curve of malignant nodules are higher than that of benign nodules. The difference between benign and malignant nodules after contrast is statistically significant (P 0.05). Conclusion 1. Conventional ultrasound is the first choice for the diagnosis of thyroid nodules, which is safe and convenient. Effective and highly reproducible noninvasive examination methods, but there are still some difficulties in the diagnosis of benign and malignant thyroid nodules. 2. The sensitivity and specificity of contrast-enhanced ultrasonography in the qualitative diagnosis of nodules. The accuracy of ultrasonography was higher than that of conventional ultrasonography, and the diagnostic ability of contrast-enhanced ultrasound was superior to that of conventional ultrasound. 3. The distribution of perfusion, enhancement degree and time-intensity curve were analyzed in the diagnosis of thyroid nodules by contrast-enhanced ultrasonography. It provides a diagnostic basis for the qualitative diagnosis of thyroid nodules and has some advantages in the qualitative diagnosis of thyroid nodules.
【學位授予單位】：遼寧醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.1

【參考文獻】

相關期刊論文 前10條

1 蔣元文;李炳翠;孫國良;周宏偉;張云亭;;甲狀腺良惡性結節(jié)的CT鑒別診斷[J];放射學實踐;2010年05期

2 陳繼;周青;柏剛;譚立國;;甲狀腺結節(jié)內(nèi)部動脈血流阻力指數(shù)對結節(jié)樣病變良惡性質(zhì)鑒別診斷價值的Meta分析[J];廣西醫(yī)學;2013年02期

3 丁利霞;;超聲彈性成像在甲狀腺不同大小占位結節(jié)診斷的價值[J];當代醫(yī)學;2013年20期

4 趙淑君;張永萍;;高頻超聲在甲狀腺良惡性結節(jié)鑒別診斷中的應用[J];吉林醫(yī)學;2012年10期

5 魏小麗;于曉玲;郝曉云;劉方義;梁萍;程志剛;韓治宇;于杰;宋志剛;;甲狀腺結節(jié)超聲引導下穿刺活檢的臨床價值[J];軍醫(yī)進修學院學報;2012年05期

6 楊帆;郭美金;吳斌;鄒文娟;李盼盼;陳媛;;超聲對甲狀腺微小乳頭狀癌的診斷價值[J];臨床超聲醫(yī)學雜志;2012年05期

7 袁惠;王丹;宋潔;牛錦東;;甲狀腺結節(jié)超聲造影定量分析[J];中國臨床醫(yī)學影像雜志;2008年06期

8 張淵;江泉;陳劍;顧曉鳴;章建全;;甲狀腺單發(fā)結節(jié)三維超聲定性診斷及其ROC曲線分析[J];中國臨床醫(yī)學影像雜志;2010年01期

9 姜玨;李苗;周琦;杜曉鵬;雷小瑩;;甲狀腺結節(jié)的超聲彈性成像和常規(guī)超聲對比分析[J];臨床超聲醫(yī)學雜志;2013年03期

10 鄭雅蘭;鄭媛媛;王谷一;;不同大小及深度的甲狀腺結節(jié)超聲彈性成像的臨床研究[J];中國臨床醫(yī)學影像雜志;2013年05期

本文編號：2004221