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目的总结甲状腺乳头状癌超声造影特征,分析超声造影定量参数与微血管密度(microvessel density,MVD)的相关性。方法 62例甲状腺乳头状癌患者均行超声造影检查,应用TomTec软件绘制时间-强度曲线获得癌组织与周围正常甲状腺组织的平均渡越时间(mean transit time,mTT)、最大峰值强度(maximum intensity,IMAX)、始增时间(rise time,RT)、达峰时间(time to peak,TTP);手术组织病理标本行免疫组织化学检查计数MVD,分析MVD与超声造影定量参数的相关性。结果 62个病灶中,60个病灶表现为不均匀低增强,2个表现为稍高增强;癌组织mTT[(30.1±11.5)s]高于周围甲状腺组织[(27.8±8.2)s],IMAX[(61.9±11.8)%]低于周围甲状腺组织[(100.0±0.0)%],差异均有统计学意义(P<0.05),RT、TTP与周围甲状腺组织比较差异无统计学意义(P>0.05);免疫组织化学结果显示癌组织CD34、CD31的MVD值分别为(38.0±6.1)、(37.9±5.1)条/高倍视野;相关分析结果显示,超声造影IMAX与MVD呈线性正相关(CD34:r=0.838,P=0.000;CD31:r=0.837,P=0.000)。结论甲状腺乳头状癌超声造影主要表现为低增强,超声造影对其定性诊断具有较大价值。
Objective To summarize the characteristics of ultrasonography of papillary thyroid carcinoma and analyze the correlation between quantitative parameters and microvessel density (MVD). Methods Sixty-two patients with thyroid papillary carcinoma underwent contrast-enhanced ultrasonography and the mean transit time (mTT) and maximum intensity (MTH) were calculated by time-intensity curve with TomTec software. IMAX, rise time (RT) and time to peak (TTP). The MVD was counted by immunohistochemistry in the histopathological specimens of the operation, and the correlation between the MVD and the quantitative parameters of CEUS was analyzed. Results Of the 62 lesions, 60 showed non-uniform enhancement and 2 showed slightly higher enhancement. The mTT in cancer tissue was (30.1 ± 11.5) s higher than that in the surrounding thyroid tissue [(27.8 ± 8.2) s], IMAX The difference was statistically significant (P <0.05). There was no significant difference between RT, TTP and surrounding thyroid tissue (P> 0.05), but there was no significant difference between thyroid tissue and surrounding thyroid tissue [(61.9 ± 11.8)%] 0.05). The results of immunohistochemistry showed that the MVD values of CD34 and CD31 in cancer tissues were (38.0 ± 6.1) and (37.9 ± 5.1) / high magnification, respectively. The correlation analysis showed that there was a linear positive correlation between IMAX and MVD : r = 0.838, P = 0.000; CD31: r = 0.837, P = 0.000). Conclusions Ultrasonography of papillary thyroid carcinoma is mainly characterized by low enhancement. Contrast-enhanced ultrasound is of great value in its qualitative diagnosis.