Research To The Diagnostic Value Of Ultrasonic Imaging And Contrast-enhanced Ultrasound To The The Benign And Malignant Thyroid Nodules

Objective:To analysis characteristics of the ultrasonic imaging and contrast-enhanced ultrasound to benign and malignant thyroid nodules, and investigate whether the contrast-enhanced ultrasound could differential diagnosis the benign and malignant thyroid nodules.Methods:Compare analysis image characteristics of ultrasonic imaging with pathology of the thyroid nodules in 512 patients, investigate image characteristics of internal echo, microcalification, amount, tissue envelope, margin, L/T, blood flow distribution, resistance of blood flow and enhancement intesity of thyroid nodules. Choose 46 patients include 55 thyroid nodules to make contrast-enhanced ultrasound. The standard of choose patient is:①Normal blood pressure;②Dubious malignant thyroid nodules;③Solid nodules;④There aren't macrocalification and large liquefy region. Apply QLAB software to analyze the difference of perfusion, enhancement pattern, PI, AT, TTP, time-intensity curve of the thyroid nodules after contrast-enhanced ultrasound, and compare these with pathology of tissue from operation or puncture. summarize blood perfusion feature of the benign and malignant thyroid nodules after contrast-enhanced ultrasound. The statistical data were analyed using the Statistical Package SPSS 17.0, p<0.05 consider have statistical significance.Results:In these 512 thyroid nodules include 393 benign thyroid nodules and 119 malignant thyroid nodules, In these malignant thyroid nodules 103 are papillocarcinoma,10 are follicular carcinoma,4 are encephaloid carcinoma and 2 are anaplastic carcinoma. The edge, tissue envelope, microcalification and echo have statistical significance between benign and malignant thyroid nodules (P<0.01) The echo, morpha, microcalification and L/T of micronodules have strong relation to what kind is the thyroid nodules(C=0.60,0.53,0.60,0.51). The 46 patients include 55 thyroid nodules which make contrast-enhanced ultrasound contain 41 malignant thyroid nodules and 14 benign thyroid nodules, In these malignant thyroid nodules 39 are papillocarcinoma,2 are encephaloid carcinoma, and there are 12 hyperplastic nodule,2 adenoma in these benign thyroid nodules. When make contrast-enhanced ultrasound to the thyroid micronodules every nodule show low enhancement intensity. The blood flow feature in thyroid ultrasonic imaging is relate to the enhancement intensity in thyroid contrast-enhanced ultrasound The difference of enhancement intensity, AT, TTP, PI between benign and malignant thyroid nodules have no statistical significance. Both thyroid nodules and normal tissue, the ascending branch of the time-intensity curve are quickly ascend, but the descend branch between them is difference, in the normal thyroid, the descend branch usually go down with smooth two-humped, and in the benign thyroid nodules, it resemble as normal, but the descend branch always turn over, and the second-humped turn shallow or disappear in the typical malignant thyroid nodules.Conclusions:①Edge is unclear, have not tissue envelope, microcalification and low echo of thyroid nodules in ultrasonic imaging have higher diagnostic value to diagnosis thyroidcarcinoma;②Very low echo, have regular shap, A/T> 1, microcalification of micronodules in ultrasonic imaging has higher diagnostic value to diagnosis microthyroidcarcinoma;③The edge of thyroid encephaloid carcinoma is clear, dosen't have halo, but in our research the amount of encephaloid carcinoma nodules is small, must confirm by large samples;④The blood flow feature in thyroid ultrasonic imaging is relate to the enhancement intensity in thyroid contrast-enhanced ultrasound;⑤When make contrast-enhanced ultrasound to the thyroid micronodules usually show low enhancement intensity, The contrast-enhanced ultrasound can't differential diagnosis between benign and malignant thyroid nodules at present.