Thyroid ultrasound contrast examination

Thyroid ultrasound contrast examination is generally suitable for the examination of thyroid nodules. If the doctor finds that the patient's thyroid nodules may have lesions, he will recommend the patient to undergo thyroid ultrasound contrast examination in order to better diagnose the disease. Patients should be adequately prepared and understand the specific examination methods before undergoing thyroid ultrasound angiography so that they will not have such a heavy psychological burden during the examination.

1. Indications

1. Used for ultrasonic diagnosis and differential diagnosis of thyroid nodules.

2. Determination of the site of puncture biopsy of thyroid nodules or lesions

3. When there are enlarged lymph nodes in the neck suspected of thyroid cancer metastasis, determine the nature of the thyroid nodules.

2. Preparation before inspection

1. Understand the patient's medical history in detail and strictly master the contraindications and adverse reactions of contrast agents.

2. Inform the patient and his/her family and have them sign the informed consent form for angiography.

3. The ultrasound examination room should be equipped with first aid supplies.

4. Thyroid puncture biopsy should be avoided before examination to avoid affecting the diagnosis.

6. Fully expose the neck area

3. Inspection Methods

After selecting the nodules that need to be observed by contrast imaging on the two-dimensional ultrasound, adjust the ultrasound instrument to the contrast imaging mode (MI is 0.05-0.08), and quickly push an appropriate amount of contrast agent through the peripheral vein (the dosage of thyroid ultrasound contrast agent is about 1.2-2.4 ml each time, and the specific amount is preferably based on the best contrast imaging effect. 4.8 ml can be used if necessary) to start the timing and dynamic image storage software, and observe the lesion boundary, enhancement direction and level, and enhancement distribution.

IV. Clinical Application

1. Differential diagnosis of benign and malignant thyroid nodules:

a. Studies have shown that most malignant thyroid nodules show centripetal or diffuse low enhancement, but some show equal enhancement and high enhancement, with uniform or uneven distribution.

b. Nodular goiter often shows diffuse equal enhancement, some show low enhancement, and no enhancement when liquefied, and the distribution may be uniform or uneven.

c. Follicular adenomas often show diffuse hyperenhancement with uniform or uneven distribution.

d. Ring enhancement around the nodule is often seen in benign nodules, especially follicular adenomas or adenomatous nodules.

2. Identify nodules after cystic fluid absorption (zombie nodules) after hemorrhagic cyst transformation: This type of nodule may show malignant signs on two-dimensional ultrasound, and it is difficult to distinguish it from malignant tumors without tracing the medical history. Ultrasound angiography of this type of nodule often shows no enhancement or a few strip-like enhancements inside the nodule, which can be distinguished from malignant tumors.

3. Monitoring of thyroid nodules after radiofrequency ablation: most nodules after ablation show no enhancement.

4. Determining the fine needle puncture point of the thyroid nodule and the area of ​​puncture contrast enhancement will help improve the positive rate of fine needle puncture.