CEUS与平面波超敏感血流显像分析甲状腺乳头状癌

Abstract

目的观察甲状腺乳头状癌(PTC)CEUS和平面波超敏感血流显像(AngioPLUS)特征。方法回顾性分析我院经手术病理证实83例PTC的CEUS表现及AngioPLUS表现,根据CEUS病灶内部强化程度将患者分为低增强组、等增强组及高增强组,比较3组间病灶峰值强度(PI)、病灶与邻近甲状腺组织峰值强度差值(ΔPI)的差异,评价PI、ΔPI与CEUS显示病灶内部强化程度的相关性以及CEUS病灶内部强化程度、PI和ΔPI与AngioPLUS显示的病灶内部微细血流分布特征的相关性。结果 3组间ΔPI差异有统计学意义(χ~2=52.35,P<0.001),其中低增强组ΔPI小于等增强组(Z=-6.45,P<0.001)和高增强组(Z=-3.99,P<0.001),等增强组ΔPI小于高增强组(Z=-3.73,P<0.001)。3组间PI差异有统计学意义(F=34.97,P<0.001),其中低增强组PI小于等增强组及高增强组(P均<0.001),而等增强组PI与高增强组间差异无统计学意义(P=0.322)。PI(r_s=0.650,P<0.001)、ΔPI(r_s=0.798,P<0.001)与CEUS显示病灶内部强化程度呈正相关。CEUS显示病灶内部强化程度(r_s=0.768,P<0.001)、PI(r_s=0.442,P<0.001)、ΔPI(r_s=0.647,P<0.001)与AngioPLUS显示的病灶内部微细血流分布特征呈正相关。结论 PTC病灶内部CEUS强化程度与AngioPLUS显示的病灶内部微细血流分布特征呈正相关,通过AngioPLUS显示的PTC病灶内部微细血流分布特征可间接评价其血流灌注。

Objective To observe manifestations of thyroid papillary carcinoma (PTC) in CEUS and planewave ultrasensitive imaging(AngioPLUS).Methods CEUS and AngioPLUS features of histopathologically proved PTC in 83 patients were retrospectively analyzed.According to CEUS enhancement,the patients were divided into hypo-enhancement group,iso-enhancement group and hyper-enhancement group.The differences of the peak intensity(PI)between lesion and adjacent thyroid tissue(ΔPI)were compared among 3 groups.The correlation of PI,ΔPI and CEUS enhancement of the lesions were evaluated,so as the correlation of CEUS enhancement,PI,ΔPI and the microvascular distribution showed with AngioPLUS.Results The differences ofΔPI among the 3 groups were statistically significant(χ~2=52.35,P<0.001).ΔPI of hypo-enhancement group was less than that of iso-enhancement group(Z=-6.45,P<0.001)and hyperenhancement group(Z=-3.99,P<0.001).ΔPI of iso-enhancement group was less than that of hyper-enhancement group(Z=-3.73,P<0.001).The differences of PI were statistically significant among 3 groups(F=34.97,P<0.001).PI of hypo-enhancement group was less than that of iso-enhancement group and hyper-enhancement group(both P<0.001).No significant difference was found for PI between iso-enhancement group and hyper-enhancement group(P=0.322).PI(r_s=0.650,P <0.001)and ΔPI(r_s=0.798,P <0.001)both had positive correlation with CEUS enhancement of the lesions.CEUS enhancement(r_s=0.768,P<0.001),PI(r_s=0.442,P<0.001)andΔPI(r_s=0.647,P<0.001)all had positive correlation with microvascular distribution demonstrated with AngioPLUS of the lesions.Conclusion CEUS enhancement of PTC showes positive correlation with microvascular distribution demonstrated with AngioPLUS of the lesions,which may be used to evaluate the perfusion indirectly of the lesions.