| Objective:By studying the contrast-enhancement characteristics of thyroid nodules,we can provide a more comprehensive basis for the accurate diagnosis of thyroid benign and malignant lesions.Methords:From September in 2017 to March in 2019,115 cases of thyroid nodule with pathological diagnosis and two-dimensional compliance with TI-RADS 4 were selected,including 70 males and 45 females,ranging in age from20 to 60 years old,and the mean ± standard value was 49±11 years old.A total of115 nodules were analyzed retrospectively,in which 80 cases of postoperative pathology known is thyroid papillary carcinoma,35 cases of postoperative pathologic known is benign nodules,30 cases are nodular goiter in benign nodules,5 cases are thyroid adenoma in benign nodules.In benign nodules,15 cases are in the left lobe and15 cases are in the right lobe,5 cases are in the isthmum.In the malignant nodules,45 cases are in the left lobe,30 cases are in the right lobe,5 cases are in the isthmum.A preliminary two-dimensional ultrasound examination was performed on 115 patients,and the diameter of the nodules ranged from 0.3 to 1.5cm.After the two-dimensional ultrasound,according to a preliminary classification of thyroid nodule signs,through the two-dimensional ultrasound,the nodules of TI – RADS 4 grade again according to the characteristics of ultrasonic imaging in this process,The enhancement intensity is divided into three categories,such as low enhancement,equal enhancement and high enhancement.The enhanced area was divided into yes and no groups;According to the filling mode of contrast agent into the lesion,it can be divided into centripetal,centrifugal and mixed.According to the relationship between thyroid nodule and capsule can be divided into contact with the capsule is not,the adjacent capsule,prominent in the capsule,capsule interruption 4 classes,the ultrasonic characteristics of contrast enhancement of statistical analysis,statistics,and calculate the two-dimensional ultrasound and ultrasound imaging of the degree of accuracy,sensitivity,specific,positive predictive value,negative predictive value,When calculating the diagnostic accuracy of two-dimensional ultrasound,ti-rads 4b and above were considered malignant;when calculating the accuracy of ultrasonography,ti-rads 4b and above were also considered malignant after further grading.Finally,the ultrasonography images of each node were retrospectively analyzed,and the time-intensity curve was made for relevant quantitative analysis and research.Results:(1)there was no significant difference in the distribution of thyroid benign and malignant nodules(P<0.05),and there was no significant difference in the distribution of thyroid benign and malignant nodules by gender(P<0.05).(2)the sensitivity of two-dimensional ultrasonic diagnosis of thyroid papillary carcinoma,specific degrees,accuracy,positive predictive value,negative predictive value were 75%,71%,73%,85%,55%,the accuracy of ultrasonic imaging in the diagnosis of thyroid papillary carcinoma were 81%,83%,81%,91%,66%,ultrasonic imaging in the diagnosis of thyroid papillary carcinoma diagnosis efficiency is higher than that of conventional ultrasound.(3)in terms of the enhancement intensity of thyroid nodules,the benign nodules were mainly of equal enhancement,accounting for 57%(20/35),and the papillary carcinoma was mainly of low enhancement,accounting for 81%(65/80).P<0.05 was statistically significant.From the perspective of the perfusion pattern of thyroid nodules,the perfusion pattern of benign nodules was mainly centrifugal(57%),and that of papillary carcinoma was mainly centripetal(70%).The difference was statistically significant at P<0.05.From the perspective of whether the area expanded after enhancement,the difference was not statistically significant(P>0.05).From thyroid nodule enhancement after relationship with the adjacent capsule,suspicious see benign and malignant involvement degree between the two groups in the capsule with statistical significance(P < 0.05),and thyroid papillary carcinoma according to the size of the diameter is divided into three groups,three groups of perfusion way,strengthen the intensity difference was statistically significant(P < 0.05),increase the heterogeneity of uniform(whether)there is no statistical significance(P > 0.05).In quantitative analysis,there were statistically significant differences between papillary carcinoma and benign nodules in peak intensity,peak time,and area under the curve.Conclusion:Thyroid TI-RADS 4 nodules which is characterized by central perfusion and low enhancement.Compared with benign nodules,thyroid papillary carcinoma has lower peak intensity,lower area under curve,and longer peak time. |
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