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

【摘要】：目的 探討甲狀腺結(jié)節(jié)的良性和惡性的超聲造影特點(diǎn)及超聲造影在甲狀腺結(jié)節(jié)良性、惡性鑒別診斷中的臨床價(jià)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(cè)和造影檢測(cè)，檢測(cè)甲狀腺結(jié)節(jié)血流灌注的分布類型、強(qiáng)化程度、分析時(shí)間-強(qiáng)度曲線，與病理結(jié)果或穿刺活檢結(jié)果相對(duì)比，，評(píng)價(jià)造影前和造影后超聲診斷的準(zhǔn)確程度。 結(jié)果 1、95例結(jié)節(jié)活檢或手術(shù)病理證實(shí)，40個(gè)良性結(jié)節(jié)和55個(gè)惡性結(jié)節(jié)。常規(guī)超聲診斷結(jié)果的敏感性占總體的72.7%，特異性占總體的87.5%，準(zhǔn)確程度為83%。 2、超聲造影診斷結(jié)果為：甲狀腺結(jié)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(zhǔn)確程度為91.6%。 3、與病理診斷的結(jié)果相對(duì)比，常規(guī)超聲檢測(cè)與超聲造影檢測(cè)結(jié)果示：甲狀腺結(jié)節(jié)良性、惡性方面差異有統(tǒng)計(jì)學(xué)意義（P0.05）。 4、超聲造影的結(jié)果提示，良性病變主要是環(huán)狀強(qiáng)化（30/40）及和高增強(qiáng)（29/40）；惡性病變?cè)煊爸饕遣痪鶆蛐缘膹?qiáng)化（50/55）和低增強(qiáng)（38/55）。 5、超聲造影結(jié)果提示：良性結(jié)節(jié)達(dá)峰時(shí)間高于惡性結(jié)節(jié)，惡性結(jié)節(jié)的曲線尖度和曲線下面積均高于良性結(jié)節(jié)，造影后的良性與惡性結(jié)節(jié)對(duì)比，差異具有統(tǒng)計(jì)學(xué)意義（P0.05）。 結(jié)論 1、常規(guī)超聲是診斷甲狀腺結(jié)節(jié)的首選方法，是一種安全、便捷、有效、重復(fù)性高的無(wú)創(chuàng)檢查手段，但在診斷甲狀腺結(jié)節(jié)良、惡性方面仍存在一定的困難。 2、超聲造影檢測(cè)技術(shù)在結(jié)節(jié)定性診斷中的靈敏度、特異度、準(zhǔn)確度均高于常規(guī)的超聲檢測(cè)，超聲造影定性診斷能力優(yōu)于常規(guī)超聲。 3、超聲造影對(duì)甲狀腺結(jié)節(jié)的診斷通過(guò)造影后灌注分布類型、強(qiáng)化程度及造影時(shí)間-強(qiáng)度曲線進(jìn)行分析，為鑒別甲狀腺結(jié)節(jié)的定性提供了診斷依據(jù)，在結(jié)節(jié)定性診斷中具有一定的優(yōu)勢(shì)。
[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(xué)位授予單位】：遼寧醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1

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本文編號(hào)：2004221