常规超声和超声造影对甲状腺囊实性结节的诊断价值

陈果; 周欣; 吕晓蓉; 杨荣; 张元庆; 郑冉; 汪延芳; 聂芳

doi:10.19732/j.cnki.2096-6210.2026.02.009

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常规超声和超声造影对甲状腺囊实性结节的诊断价值

论著 | 更新时间：2026-05-07

- 常规超声和超声造影对甲状腺囊实性结节的诊断价值
- The value of conventional ultrasound and contrast-enhanced ultrasound in the diagnosis of partially cystic thyroid nodules
- 肿瘤影像学 2026年35卷第2期页码：291-300
- 作者机构：
  
  1.兰州大学第二医院超声医学中心，甘肃兰州 730030
  2.甘肃省超声影像临床医学研究中心，甘肃兰州 730030
  3.甘肃省智能超声医学工程研究中心，甘肃兰州 730030
  4.甘肃省介入超声装备应用行业技术中心，甘肃兰州 730030
- 作者简介：
  
  NIE Fang E-mail: ery＿nief@lzu.edu.cn
- 基金信息：
  
  兰州大学第二医院萃英科技计划优秀博士基金项目(CY2022-YB-B02);甘肃省人才计划（青年人才）项目(2025QNGR25)
- DOI：10.19732/j.cnki.2096-6210.2026.02.009
  中图分类号： R736.1;R445.1
- 收稿：2025-12-03，
  
  修回：2026-02-12，
  
  纸质出版：2026-04-28
- 稿件说明：
移动端阅览
陈　果, 周　欣, 吕晓蓉, 等. 常规超声和超声造影对甲状腺囊实性结节的诊断价值［J］. 肿瘤影像学, 2026, 35(2): 291-300.

CHEN G, ZHOU X, LÜ X R, Citation:et al. The value of conventional ultrasound and contrast-enhanced ultrasound in the diagnosis of partially cystic thyroid nodules［J］. Oncoradiology, 2026, 35(2): 291-300.
陈　果, 周　欣, 吕晓蓉, 等. 常规超声和超声造影对甲状腺囊实性结节的诊断价值［J］. 肿瘤影像学, 2026, 35(2): 291-300. DOI： 10.19732/j.cnki.2096-6210.2026.02.009.

CHEN G, ZHOU X, LÜ X R, Citation:et al. The value of conventional ultrasound and contrast-enhanced ultrasound in the diagnosis of partially cystic thyroid nodules［J］. Oncoradiology, 2026, 35(2): 291-300. DOI： 10.19732/j.cnki.2096-6210.2026.02.009.

摘要

目的

探讨常规超声和超声造影（contrast-enhanced ultrasound，CEUS）对甲状腺囊实性结节（partially cystic thyroid nodules，PCTN）的鉴别诊断价值。

方法

回顾并连续收集2019年1月—2025年7月在兰州大学第二医院行常规超声、CEUS检查的PCTN的患者。术前行常规超声及CEUS检查，以病理学检查结果为标准，采用单因素及多因素logistic回归明确恶性PCTN的独立预测因子，并构建联合预测模型，通过受试者工作特征（receiver operating characteristic，ROC）曲线评估其预测效能，并通过DeLong检验比较联合预测模型及单独应用的诊断效能。

结果

共纳入164例患者（共173个囊实性结节），其中90例恶性PCTN（共91个结节），74例良性PCTN（共82个结节）。常规超声所示整个结节形态不规则、边界不清、纵横比≥1，内部实性成分占比≥50%、低回声、微钙化、实性成分偏心锐角；CEUS所示整个结节增强边界不清、无环状高增强，内部实性成分呈低增强、不均匀增强、非向心性“烟花样”增强、消退早于周围正常甲状腺组织与恶性PCTN相关。微钙化、纵横比≥1、增强边界不清、非向心性“烟花样”增强是恶性PCTN的独立预测因素。单一CEUS诊断恶性PCTN的AUC高于单一常规超声，但差异无统计学意义（

=0.188，

=-1.632）。常规超声联合CEUS诊断恶性PCTN的AUC均高于单一常规超声及单一CEUS（0.987

0.925、0.962，均

0.05）。

结论

常规超声联合CEUS可显著提高对PCTN的诊断效能，有助于降低恶性PCTN的漏诊率和误诊率，为临床决策提供更为可靠的参考依据。

Abstract

Objective

To investigate the diagnostic performance of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in differentiating malignant from benign partially cystic thyroid nodules (PCTN).

Methods

A retrospective and consecutive study of patients with PCTN who underwent conventional ultrasound and CEUS examinations at the Second Hospital of Lanzhou University from January 2019 to July 2025 was conducted. Conventional ultrasound and CEUS examinations were performed

and the pathological results were taken as the standard. Univariate and multivariate logistic regression were used to identify the independent predictors of malignant PCTN

and a combined predictive model was constructed. The predictive efficacy of the model was evaluated by the receiver operating characteristic (ROC) curve

and the diagnostic efficacy of the combined predictive model and the individual application was compared by DeLong test.

Results

A total of 164 patients (with 173 PCTN) were included

among which 90 cases were malignant PCTN (with 91 nodules) and 74 cases were benign PCTN (with 82 nodules). Conventional ultrasound showed that the entire nodule had an irregular shape

unclear boundary

taller-than-wide≥1

solid component proportion≥50%

hypoechoic

microcalcification

and eccentric acute angle of solid component. CEUS showed that the entire nodule had unclear enhancement boundary

no peripheral hyper-enhancing rim

and the solid component inside presented with hypo-enhancement

inhomogeneous enhancement

non-central "firework-like" enhancement

and earlier regression than the surrounding normal thyroid tissue

which were related to malignant PCTN. Microcalcifications

taller than wide

unclear enhancement boundaries

and non-centripetal “fireworks-like” enhancement were independent predictors of malignant PCTN. The area under the curve (AUC) for CEUS alone in diagnosing malignant PCTN was higher than that for conventional ultrasound alone

however

the difference was not statistically significant (

0.188

=-1.632). Notably

the AUC for the combination of conventional ultrasound and CEUS was significantly higher than that for either modality alone (0.987

0.925 and 0.962

respectively; both

0.05).

Conclusion

Conventional ultrasound combined with CEUS significantly enhances diagnostic efficacy for PCTN

helping to reduce the rates of missed diagnosis and misdiagnosis of malignant PCTN

thereby providing more reliable reference for clinical decision-making.

关键词

Keywords

references

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