The Value Of Contrast-enhanced Patterns In Differential Diagnosis And Contrast-enhanced Curve Of Benign And Malignant Thyroid Nodules

Objective:To study the value the enhancement patterns for the differential diagnosis of benign and malignant thyroid nodules.Methods:A retrospective analysis of 34 cases of thyroid nodules in Department of general surgery and Department of hepatobiliary surgery in the CALMETTE Hospital of Affiliated Kunming Medical University from December 2015 to August 2016.all nodules were examined by thyroid and CEUS,and the results of benign and malignant pathology were compared.QLAB quantitative analysis software was used to analyze the time and intensity curve of blood perfusion characteristics of benign and malignant thyroid nodules.LDRW-WIWO curve fitting ultrasound mean was used to derive the following clinical parameters.TP:increased from 10%PI to 90%PI the time for the peak intensity,PI:refers to the highest level of intensity,contrast agent perfusion with the highest intensity level of the surrounding thyroid tissue was 100%,MTT:refers to the required from the time the TIC curve begins to rise to drop to 50%PI,AUC:refers to the sum of total area of TIC under the curve.Independent sample t test was used to compare the quantitative parameters TP,PI,MTT,AUC of thyroid benign nodules and malignant thyroid nodules,benign nodules of thyroid and thyroid tissue around the lesion,thyroid malignant nodules and thyroid tissue around the lesion.analysis of the benign nodules and the surrounding thyroid tissue curve trend and malignant nodules and the surrounding thyroid curve of the trend of whether there is a difference.Results:1 Benign nodules were parameters of TP:5.52+2.18,PI:10.04±3.18,MTT:47.22±21.86,AUC:508.26±262.1;malignant nodules were parameters of TP:7.82±4.54,PI:6.46± 1.35,MTT:27.85± 17.84,AUC:234.35± 107.7,benign and malignant nodules TP P value>0.05,the difference was not statistically significant,PI,MTT,AUC,P the value is less than 0.05,the difference was statistically significant.1.1 Comparing the results of CEUS between benign nodules to surrounding normal tissue The TP of benignnodules:5.52±2.18,the TP of surrounding normaltissue:5.72±2.29,P=0.79 The PI of benign nodules:10.04±3.18,the PI of surrounding normal tissue:10.50±2.59,P=0.65 The MTTof benign nodules:47.22±21.86,the MTT of surrounding normal tissue:47.58± 21.57,P=0.96 The AUC of benign nodules:508.06±262.12The AUC of surrounding normal tissue:541.91 ±292.4,P=0.72 All parameters P>0.05,the difference was not statistically significant.2 Comparing the results of CEUS malignant thyroid nodules nodules to surrounding normal tissueThe TP of malignant nodules:7.82±4.54,the TP of surrounding normal tissue:4.95±4.18,P=0.93,P>0.05,the difference was not statistically significant;The MTT of malignant nodules:27.85± 17.84,he MTT of surrounding normal tissue:37.26±21.63,P=0.19,P>0.05,the difference was not statistically significant?The PI of malignant nodules:6.46 ± 1.35,the PI of surrounding normal tissue:8.65±l.85,P=0.001,P?0.05,the difference was statistically significant.The AUC of malignant nodules:234.35±107.7,The AUC of surrounding normal tissue:344.8± 156.47,P=0.09,P?0.05,the difference was statistically significant.3 Curve trend of shape:Most nodular goiter contrast-enhanced ultrasound curves were compared with normal tissue,and the difference was not significant.Compared with the normal tissues,the trend of contrast-enhanced ultrasound in the papillary carcinoma showed a large difference,showing a low enhancement,and the peak intensity and the area under the curve were all smaller than those of normal tissues,which is consistent with the above results4 Benign thyroid nodules after angiography are clear boundary,regular shape,high strength,etc.to see more,strengthen the approximate to or higher than the surrounding normal thyroid tissue;malignant nodules of thyroid angiography after the boundary is not clear and irregular shape,strengthening mainly low and non-enhancement;with statistical significance in benign and malignant thyroid nodular enhancement the type of difference.Ring-shaped enhancement appears more in benign nodules.The peak intensity of thyroid papillary carcinoma and the area under the curve are less than the benign nodules,and the difference is statistically significant(P?0.05).Conclusions:The characteristics of benign and malignant thyroid nodules are different.Quantitative analysis of the time-intensity curve of contrast-enhanced ultrasound can show different perfusions of thyroid tissue and its internal nodules.There are some overlaps between Contrast-enhanced features of some thyroid benign and malignant nodules and time-intensity curves.In the quantitative parameters,the PI and the AUC can be used as an important reference index in the differential diagnosis of thyroid benign nodules and papillary thyroid carcinomas.The running trend of CE-curve has certain reference value compared with surrounding thyroid tissue trend chart.