Reasearch Of Diagnostic Value Of Ultrasonography In Thyroid Follicular Neoplasms

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Value of ultrasonography combined with preoperative serum thyroglobulin in diagnosis of thyroid follicular carcinomasObjective:To investigate the value of routine ultrasound and preoperative serum thyroglobulin?Tg?in the diagnosis of thyroid follicular carcinomas,and establish a multivariate diagnostic model for the diagnosis of thyroid follicular carcinoma by ultrasound combined with preoperative serum thyroglobulin.Methods:The clinical features and sonographic data of 175 thyroid follicular neoplasmss in 162 patients confirmed by pathology were analyzed retrospectively.Univariate analysis was used to compare the differences between thyroid follicular carcinomas and thyroid adenomas.Logistic regression analysis was used to find independent risk factors for thyroid follicular carcinomas,and to establish a Multivariate diagnostic model.The receiver operating characteristic curve?ROC?was used to compare the diagnostic value of the Multivariate model with preoperative serum thyroglobulin,two-dimensional ultrasound,color Doppler ultrasound,and the combination of two-dimensional ultrasound and color Doppler ultrasound.Results:1.In this study,univariate analysis revealed that there were differences between thyroid follicular carcinomas and thyroid adenomas in gender,preoperative serum Tg,nodule size,echo homogeneity,cystic degeneration,shape,halo,internal blood flow,and peripheral blood flow?P<0.05?.Among them,male,elvated serum Tg,larger nodules,heterogeneous echotexture,no cystic degeneration,irregular shape,no halo or irregular halo,rich internal blood flow and no peripheral color flow were associated with thyroid follicular carcinomas.2.The multivariate binary logistic regression analysis found that preoperative serum Tg higher than 92.195 ng/mL,heterogeneous echotexture,no regular thin halo,rich internal blood flow,and no peripheral color flow were independent risks of thyroid follicular carcinomas,while male,the largest diameter greater than 30.5mm,no cystic degeneration,and irregular shape were not independent risk factors for thyroid follicular carcinoma.3.In the diagnosis of thyroid follicular carcinomas,the sensitivity of preoperative serum Tg was 68.2%,the specificity was 69.7%,and the accuracy was 69.1%.The sensitivity of two-dimensional ultrasound was81.8%,the specificity was 73.4%,and the accuracy was 76.6.%;color Doppler ultrasound had a sensitivity of 50%,specificity of 100%,accuracy of 81.1%.Combination of two-dimensional ultrasound color Doppler ultrasound diagnosis of thyroid follicular carcinoma had a sensitivity of90%,specificity of 75.2%,accuracy of 81.1%;the sensitivity of the Multivariate diagnostic model was 81.8%,specificity was 90.8%,accuracy was 87.4%and AUC was 0.940.4.There were no statistical differences in age,preoperative serum FT₃,FT₄,TSH,TgAb,TPOAb,nodule aspect ratio,echo,location,morphology,border,calcification,PSV,EDV,RI,and elasticity score?P>0.05?.Conclusion:1.Preoperative serum Tg levels were higher in patients with thyroid follicular carcinoma patients than patients with thyroid adenoma.2.Thyroid follicular carcinomas and thyroid adenomas shared a similar ultrasonographic appearance of soft,clear boundaries,rare internal calcifications,hypoechoic or echogenic nodules.If there are patients with preoperative serum Tg higher than 92.195ng/mL,heterogeneous echotexture,no cystic change,no regular halo,rich internal blood flow,no peripheral flow,the possibility of thyroid follicular carcinomas should be taken into consideration.3.Preoperative serum Tg,two-dimensional ultrasound or color Doppler ultrasound had limitations in diagnosis of thyroid follicular carcinomas.The combination of two-dimensional ultrasound color Doppler ultrasound can improve the diagnostic sensitivity.The Multivariate diagnosis model is superior to either preoperative serum Tg,two-dimensional ultrasound,color Doppler ultrasonography,or combined application of two-dimensional ultrasound and color Doppler ultrasound,and has higher clinical application value.4.Ultrasound elastography had little value in differential diagnose of thyroid follicular neoplasms.Section ? Value of contrast-enhanced ultrasonography in differential diagnosis of follicular thyroid neoplasmsObjective:To explore the value of contrast-enhanced ultrasound in the differential diagnosis of thyroid follicular neoplasms by retrospectively analyzing the characteristics of contrast-enhanced ultrasound of thyroid follicular carcinoma and thyroid adenoma.Methods:The contrast-enhanced ultrasound images of 46 thyroid follicular neoplasms in 45 patients confirmed by pathology were retrospectively analyzed and compare the differences in the features of contrast-enhanced ultrasound,then the value of contrast-enhanced ultrasound in the differential diagnosis of thyroid follicular neoplasms were calculated.Results:1.Contrast-enhanced ultrasound showed a statistically significant difference in the ring enhancement between thyroid follicular carcinomas and thyroid adenomas?P<0.05?,and no ring enhancement was associated with thyroid follicular carcinoma.2.There were no significant difference in perfusion pattern,perfusion uniformity,time to peaks,peak intensity,remission speed,and remission pattern between thyroid follicular carcinomas and thyroid adenomas?P>0.05?.3.No ring enhancement in the diagnosis of thyroid follicular carcinoma had a sensitivity of 84.2%,a specificity of 48.1%,an accuracy of 63%,and the AUC was 0.662.Conclusion:1.Thyroid follicular carcinomas and thyroid adenomas were similar contrast-enhanced ultrasonography.They were both hyperenhanced,perfusion at the same time,perfusion earlier than the surrounding thyroid tissue,and remission earlier than the surrounding thyroid tissue and slowly remission.No ring enhancement was associated with thyroid follicular carcinoma.2.There was limitation in diagnosing thyroid follicular carcinomas only by no ring enhancement in contrast-enhanced ultrasound.