| Objective:(1)The difference in perfusion measurements of histo-pathologically proven papillary thyroid carcinoma(PTC)with different nodule sizes,and with or without cervical lymph node metastases were studied,and the purpose of the present study was to provide pathologic basis for different perfusion measurements and to assess the value of CEUS examination in diagnosis of PTC and prediction of the metastasis of lymph nodes.(2)This study sought to determine whether there is any correlation between quantitative parameters of blood perfusion with ultrasonographic measurements and different blood vessel markers of microvessel density(MVD),microvessel area(MVA).And to assess the value of CEUS examination in evaluating micro-vascularization in patients with PTC treated with targeted therapy.Methods:Between April 2014 and October 2016,a total of sixty-nine patients who had known PTC and underwent CEUS examination in the Affiliated Hospital of Qingdao University were recruited in our study.The final diagnosis was obtained based on histological findings.In this study,the perfusion measurements of CEUS imaging of sixty-nine nodules were retrospectively analyzed.All the nodules were divided into <1 cm group,1-2 cm group and >2.0 cm group based on the diameter size,and simultaneously,neck lymph node metastatic and nonmetastatic group based on pathologic findings of lymph node.All images were assessed retrospectively and Peak Intensity(Peak),area under the curve(AUC),Time to Peak(TTP)and mean Transit Time(MTT)obtained from time-intensity curve(TIC)were calculated.Surgical specimens were stained with hematoxylin and eosin and expression of CD34,the endothelial cell marker,was determined by immunohistochemical straining to quantify the MVD,MVA.Then the relationship between perfusion measurements and the level of MVD,MVA were evaluated by Spearman's Rank correlation analysis.Results:(1)Compared with the healthy parenchyma in corresponding thyroid,the level of Peak,AUC,MVD and MVA of thyroid nodules were lower(t=-8.700,-11.061,-14.377and-20.532,all P<0.05).TTP,MTT tend to show differences between PTC and healthy tissue,however did not reach the level of significance.(2)Our results suggest that thebigger nodules had rich level of Peak,AUC,MVD and MVA than the nodules with smaller diameters(F=15.643,14.688,15.485 and 21.140,all P<0.05).(3)The results also demonstrated that PTC with cervical lymph node metastases had significantly higher level of Peak,AUC,MVD and MVA than those without metastases(t=3.177,4.366,6.336 and4.742,all P<0.05).(4)Peak,AUC showed specific correlation with MVD(r=0.506,0.478,both P<0.05)and there was a significant specific correlation between Peak,AUC and MVA(r=0.648,0.653,both P<0.05).By contrast,TP,MTT and MVD,MVA showed no correlation(all P >0.05).Conclusion :(1)The study showed that CEUS imaging quantifiable parameters are associated with nodule size and the metastasis of cervical lymph nodes to a certain extent.Therefore,CEUS examination offered new possibilities for providing an excellent non-invasive imaging modality for clinical diagnosis and prediction of prognosis of PTC.(2)The level of perfusion measurements can reflect MVD and MVA of PTC,and CEUS imaging with perfusion analysis may be a useful adjunct for the dynamic evaluation of pathological angiogenesis in PTC before operation. |
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