超声造影与超声弹性成像评价桥本甲状腺炎背景下甲状腺癌及颈部淋巴结转移的价值

目的：探索超声造影与超声弹性成像对桥本甲状腺炎（HT）背景下甲状腺癌的评价及颈部淋巴结转移相关。方法：选取的137例HT背景下甲状腺病变患者均在2021年1月至2022年3月期间收集，均进行超声弹性成像、超声造影检查，经ROC曲线分析超声弹性成像、造影诊断效能。同时针对HT背景下甲状腺癌患者有无颈部淋巴结转移分为两组，即有转移组（n=41），无转移组（n=38），比较两组超声定量参数，且经相关性分析超声定量参数与甲状腺癌颈部淋巴结转移相关性。结果：超声造影诊断HT背景下甲状腺病变准确率84.67%，超声弹性成像诊断准确率72.99%，两项联合诊断准确率94.16%，经ROC曲线分析，超声弹性成像、超声造影、两项联合诊断HT背景下甲状腺癌的AUC分别为0.727、0.844、0.940。有转移组患者TTP（14.32±4.58）s、MTT（28.46±8.42）s低于无转移组，弹性比值（2.51±0.51）高于无转移组（P＜0.05），经Spearman法分析，TTP、MTT与颈部淋巴结转移呈负相关，与弹性比值呈正相关；经ROC曲线分析，TTP、MTT、弹性比值、三项联合早期诊断HT背景下甲状腺癌颈部淋巴结转移的AUC分别为0.788、0.772、0.767、0.948。结论：超声弹性成像联合超声造影诊断HT背景下甲状腺癌以及颈部淋巴结转移情况具有较高效能，对临床有一定指导价值。 【关键词】：超声造影；超声弹性成像；桥本甲状腺炎；甲状腺癌；颈部淋巴结转移；相关

Evaluation of contrast-enhanced ultrasound and ultrasound elastography in thyroid cancer under Hashimoto""s thyroiditis and correlation analysis of cervical lymph node metastasis

Abstract]: Objective: To explore the correlation between contrast-enhanced ultrasound and ultrasound elastography in the evaluation of thyroid cancer and cervical lymph node metastasis in the context of Hashimoto thyroiditis (HT). Methods: 137 patients with thyroid lesions under HT background were collected from January 2021 to March 2022. All patients underwent ultrasonic elastography and contrast-enhanced ultrasonography. The diagnostic efficacy of ultrasonic elastography and contrast-enhanced ultrasonography was analyzed by ROC curve. At the same time, according to whether thyroid cancer patients have cervical lymph node metastasis under the background of HT, they are divided into two groups, namely metastasis group (n = 41) and non metastasis group (n = 38). The quantitative parameters of ultrasound in the two groups are compared, and the correlation between quantitative parameters of ultrasound and cervical lymph node metastasis of thyroid cancer is analyzed. Results: the accuracy of contrast-enhanced ultrasound in the diagnosis of thyroid lesions under HT background was 84.67%, the accuracy of ultrasound elastography was 72.99%, and the accuracy of two combined diagnosis was 94.16%. The AUC of ultrasound elastography, contrast-enhanced ultrasound and two combined diagnosis of thyroid cancer under HT background were 0.727, 0.844 and 0.940 respectively. Time To Peak (14.32 ± 4.58) s and Mean Transit Time (28.46 ± 8.42) s in patients with metastasis were lower than those in patients without metastasis, and the elastic ratio (2.51 ± 0.51) was higher than that in patients without metastasis (P < 0.05). By Spearman method, TTP and MTT were negatively correlated with cervical lymph node metastasis and positively correlated with elastic ratio; By ROC curve analysis, the AUC of TTP, MTT, elastic ratio and three combined early diagnosis of cervical lymph node metastasis of thyroid cancer under the background of HT were 0.788, 0.772, 0.767 and 0.948 respectively. Conclusion: ultrasound elastography combined with contrast-enhanced ultrasound is highly effective in the diagnosis of thyroid cancer and cervical lymph node metastasis under the background of HT, and has a certain guiding value for clinical practice. Key words]: contrast-enhanced ultrasound; Ultrasonic elastography; Hashimoto thyroiditis; Thyroid cancer; Cervical lymph node metastasis; relevant