To Explore The Value Of Multimodal Ultrasound In The Diagnosis Of Thyroid Nodule

Objective: To explore the value of multi-modal ultrasound in the differential diagnosis of benign and malignant thyroid nodules and to provide the best method for the differential diagnosis of thyroid diseases.Methods: Retrospective analysis of 92 lesions in 76 patients with thyroid nodules in Department of Oncology,affiliated Hospital of Qinghai university.After routine ultrasound examination,switch to elastic mode and score according to color difference.After obtaining the consent of the patient and signing the informed consent,switched to the mode of contrast-enhanced ultrasound.After the injection of ultrasound Sono Vue through the cubital vein mass,the dynamic course of perfusion was observed and recorded for 3 minutes,and the offline analysis was performed.Observation of nodular enhancement model and quantitative parameters of time-intensity curve obtained by using analysis software: Peak intensity(PEAK),peak time(TP),average transit time(MTT)and area under curve(AUC)were analyzed,and contrast-enhanced ultrasonography was made.After ultrasound guided fine needle puncture examination,all the examinations were based on postoperative pathology as gold standard,and the results were statistically analyzed,and the value of multimodal technique in the diagnosis of thyroid nodules was compared and analyzed.Results:1.92 thyroid nodules,of which 48 were benign,35 with a score of ? 3,mainly blue-green and green.Thyroid nodules were examined with contrast medium.Most of the benign nodules were earlier than the peripheral normal glandular tissues,and later than the peripheral glandular tissues.The curve was generally "rapid rise and slow decline".Most nodules showed homogeneous enhancement and annular enhancement pattern.2.Of the 44 malignant nodules,31 were with elastic score ? 4,and the center of the lesion was mainly blue.The contrast medium was later than the normal glandular tissue around the nodule,and earlier than the exiting of the peripheral gland.The curve was "slow ascending and descending" in general.Most nodules showed Heterogeneous enhancement and non-enhancement pattern.There were certain differences in the parameters of PEAK,TP,AUC and MTT of benign and malignant nodules.3.The coincidence rate of elastic imaging combined with contrast-enhanced ultrasonography in the differential diagnosis of benign and malignant thyroid nodules is 90.2%.The coincidence of Contrast-enhanced ultrasound combined elastic imaging in thyroid nodule diagnosis was 90.2%,which was higher than the single ultrasonic elastography(71.7%)or single contrast-enhanced ultrasonography(77.2%).There was no significant difference in coincidence rate between combined technique and ultrasound guided fine needle puncture.Conclusion: Elastic imaging is more accurate than conventional ultrasound in evaluating the soft and hard degree of nodules.Contrast-enhanced ultrasonography can more accurately display the characteristics of blood supply in the marginal and central regions of the lesion.The accuracy of fine needle puncture,to a certain extent,can be used as the first choice for the identification of good and bad thyroid nodules.There were some differences in quantitative parameters between benign and malignant nodules.This provides a useful clue for further study of the growth of thyroid nodules,and provides a theoretical basis for the definition of the scope of surgical removal of thyroid nodules.