超声造影评价甲状腺结节激光消融疗效的应用-东南大学学报医学版

超声造影评价甲状腺结节激光消融疗效的应用

单位：1. 东南大学附属江阴市人民医院乳甲外科, 江苏江阴 214400;
2. 东南大学附属江阴市人民医院超声科, 江苏江阴 214400

分类号：R581.3;R445.1

出版年·卷·期（页码）：2016·35·第一期（36-40）

摘要：

目的:评价超声造影在甲状腺良性结节激光消融术中的应用价值。方法:对10个甲状腺良性结节行超声引导下激光消融治疗,对病灶术前、术后15 min及术后1、3、6、9、12个月分别行二维超声、彩色多普勒超声及超声造影进行疗效评估。结果:消融前彩色多普勒血流显像在5个甲状腺结节内部及边缘检出有彩色血流信号,而超声造影在全部10个甲状腺结节内部及边缘检出有彩色血流信号,差异有统计学意义(P<0.05);激光消融结束后超声显示10个结节呈无造影剂灌注的边界清晰的无回声区,超声造影显示6个结节边缘有少量不规则的造影剂灌注的残余组织(P<0.05)。术后1、3、6、9、12个月复查结节体积较治疗前有不同程度缩小,超声造影显示结果明显优于常规彩超。结论:超声造影较常规彩超对甲状腺激光消融治疗具有优势性指导作用。

Objective:To evaluate the value of contrast-enhanced ultrasound in the laser ablation diagnosis of benign thyroid nodules. Methods:10 benign thyroid nodules underwent ultrasound-guided percutaneous laser ablation (PLA),and contrast-enhanced ultrasound (CEUS) were evaluated in the preoperative, 15 minutes after operation and 1, 3, 6,9,12 months after the treatment respectively.The findings were compared with 2-dimensional ultrasound and color doppler ultrasound (CDUS). Results:Before treatment, Blood flow signal was detected by CDUS in the edge and inner regions in 5 thyroid nodules, and it was detected by CEUS in all 10, the difference was statistically significant(P<0.05). 15 minutes after treatment, CDUS showed no contrast agent perfusion in all 10,while CEUS showed a small amount of irregular contrast agent perfusion at the edge of 6,which suggest the tissue residues(P< 0.05). 1, 3, 6, 9 and 12 months after the treatment,the nodules were reduced to different degrees, and the result of CEUS was significantly superior to that of CDUS. Conclusion:CEUS has advantages over CDUS in evaluating the treatment of PLA for thyroid nodule.

参考文献：

[1] PACELLA C M,BIZZARRI G,GUGLIELMI R,et al.Thyroid tissue:US-guided percutaneous interstitial laser ablation-a feasibility tudy[J].Radiology,2000,217(3):673-677.
[2] LEYENDECKER J R,DODD G D,HALFF G A,et al.Sonographically observed echogenic response during intraoperative radio-frequency ablation of cirrhotic livers:pathologic correlation[J].AJR Am J Roentgenol,2002,178(5):1147-1151.
[3] DØSSING H,BENNEDBÆK F N,HEGEDVS L.Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules[J].Eur J Endocrinol,2011,165(1):123-128.
[4] VALCAVI R,RIGANTI F,BERTANI A,et al.Percutaneous laser ablation of cold benign thyroid nodules:a 3-year follow-up study in 122 patients[J].Thyroid,2010,20(11):1253-1261.
[5] DØSSING H,BENNEDBAEK F N,KARSTRUP S,et al.Benign solitary solid cold thyroid nodules:US-guided interstitial laser photocoagulation-initial experience[J].Radiology,2002,225(1):53-57.
[6] FRIEDRICH-RUST M,SPERBER A,HOLZER K,et al.Real-time elastography and contrast-enhanced ultrasound for the assessment of thyroid nodules[J].Exp Clin Endocrinol Diabetes,2010,118:602-609.
[7] ZHANG B,JIANG Y X,LIU J B,et al.Utility of contrast enhanced ultrasound for evaluation of thyroid nodules[J].Thyroid,2010,20:51-57.
[8] 郝晶,熊雅玲,王辉,等.超声造影定量分析对甲状腺实性结节的初步研究[J].中华超声影像学杂志,2011,7(7):638-639.
[9] 杨琛,钱超文,朱慧,等.超声造影定量分析对甲状腺结节血流灌注的研究[J].中华超声影像学杂志,2011,20(1):38-40.
[10] ARGALIA G,de BERNARDIS S,MARIANI D,et al.Ultrasonographic contrast agent:evaluation of time-intensity curves in the characterisation of solitary thyroid nodules[J].Radiol Med(Torino),2002,103(4):407-413.
[11] SCHLOSSER T,POLD C,KUNTZ-HEHNER S,et al.Echoscintigraphy:a new imaging modality for the reduction of color blooming and acoustic shadowing in contrast sonography[J].Ultrasound Med Biol,2003,29:985-991.
[12] 章健全,马娜,徐斌,等.超声引导监测下经皮射频消融甲状腺腺瘤的方法学研究[J].中华超声影像学杂志,2010,19(10):861-865.
[13] LIU J B,GOLDBERG B B,MERTON D A,et al.The role of contrast-enhanced sonography for radiofrequency ablation of liver tumors[J].J Ultrasound Med,2001,20(5):517-523.
[14] EDWARD L,SENTHIL K,SHAHID A K,et al.Contrast-enhanced 3D ultrasound in the radiofrequency ablation of liver tumors[J].World J Gastroenterol,2009,15(3):289-299.
[15] 仉立辉,宫建,李宁,等.老年男性2型糖尿病患者甲状腺结节的超声特征[J].东南大学学报:医学版,2015,34(3):373-375.
[16] 吴云爽,姚志勇,张天艳.超声引导下经皮细针穿刺聚桂醇治疗甲状腺囊性结节疗效分析[J].现代医学,2015,43(8):1046-1048.

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