| Objective:To study the enhancement mode and the young’s modulus and shear wave velocity of thyroid microcarcinoma.Objective to investigate the clinical value of contrast-enhanced ultrasound and shear wave elastography in the diagnosis of thyroid microcarcinoma.Methods:From March 2015 ~2016 year in August in the first hospital of Shanxi Medical University underwent ultrasound examination revealed thyroid small nodules(maximum diameter less than or equal to 1cm)followed by surgical treatment of 83 patients with134.All patients underwent contrast-enhanced ultrasound(Contrast-enhanced ultrasound,CEUS)before and after operation.The contrast agent Sono was injected into the cubital vein to observe the enhancement pattern of thyroid nodules in Vue.Real time shear wave elastography(Shear wave elastography,SWE)was used to measure Young’s modulus and shear wave velocity.Based on the pathological results,the specificity and sensitivity of CEUS and SWE in the diagnosis of thyroid microcarcinoma were evaluated on the basis of conventional ultrasound.Results:(1)83 cases of 134 thyroid small nodules were contrast-enhanced ultrasound(CEUS)examination: the papillary thyroid microcarcinoma 88,1 medullary carcinomas;small benign thyroid nodules were 45: 42 nodular goiter,1 adenomas,1 hyperplastic nodules,1subacute thyroiditis.1 Thyroid small nodules enhanced CEUS model in this study is defined as 4enhanced mode: high enhancement,equal enhancement,low enhancement and circular enhancement(just focus surrounding a circular reinforced structure,enhanced uniformity can ring structure is complete can).In this study,89 thyroid microcarcinoma(high enhancement 6,equal enhancement 23,low enhancement 58,circular enhancement2),a total of 45 small benign nodules(high enhanced 3,equal enhancement 32,low enhancement 5,ring enhancement 5).2 Thyroid microcarcinoma 65.17%(58/89)showed low enhancement,and the sensitivity of the diagnosis of thyroid microcarcinoma with low enhancement was about65.17%,with a specificity of 88.89%.Smallenign thyroid nodules 71.11%(32/45)showed equal enhancement,and the sensitivity of the diagnosis of small benign nodules was equal to 71.11%,and the specificity was about 74.16%.(2)83 cases with 134 small nodules underwent real-time shear wave elastography(SWE)examination: the papillary thyroid microcarcinoma 88,1 medullary carcinomas;small benign thyroid nodules were 45: 42 nodular goiter,1 adenomas,1 hyperplastic nodules,subacute thyroid inflammation1 SWE Young’s modulus maximum value of Emax diagnosis of thyroid microcarcinoma has statistical significance,with 34.15 k Pa as the diagnostic value,the sensitivity is 90.9%.The specificity was 98.2%.SWE mean value of Young’s modulus of Emean was statistically significant in the diagnosis of thyroid microcarcinoma.The sensitivity of 26 k Pa was 79.7%.The specificity was 94.5%.2 The maximum value of SWE shear wave velocity(Vmax)in the diagnosis ofthyroid microcarcinoma was statistically significant.The 3.35m/s value was 84.8%.The specificity was 96.4%.The average value of SWE shear wave velocity of Emean was statistically significant in the diagnosis of thyroid microcarcinoma.The diagnostic value of 2.15m/s was 76.7%.The specificity was 94.5%.3SWE Young’s modulus minimum Emin,shear wave velocity minimum Vmin had no statistical significance in the diagnosis of thyroid microcarcinoma.Conclusion:(1)the two dimensional sonographic features of thyroid microcarcinoma were unclear boundary,irregular shape and microcalcification.(2)Contrast enhanced ultrasound showed that 65.17% of thyroid microcarcinoma showed low enhancement,and small benign nodules showed equal enhancement in the other 71.11%.(3)the maximum and mean values of Young’s modulus of shear wave elastography,the maximum and average shear wave velocity can all be used to diagnose thyroid microcarcinoma.(4)In the diagnosis of thyroid microcarcinoma,the sensitivity and specificity of shear wave elastography were higher than those of contrast enhanced ultrasound. |
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