Advances and Future Prospects in Thyroid Contrast-Enhanced Ultrasound (2021-2024).

内容摘要

Thyroid nodules are a common clinical condition of the endocrine system,and their diagnosis and differential diagnosis remain a serious challenge in the medical community.Since the first observation of acoustic enhancement in 1969,contrast-enhanced ultrasound (CEUS) has gradually matured through two major phases:the development of contrast agents (1990s) and the innovation of imaging algorithms (early 21st century).Since being introduced into clinical practice in China,2003,CEUS has undergone over two decades of localized development.Its capability for microcirculation perfusion imaging has established it as a core imaging tool for dynamic blood flow assessment in critical clinical scenarios,including the distinguishing between benign and malignant nodules,early cancer screening,and the formulation of individualized treatment plans.In recent years,with the advancements in instrument performance and the emergence of novel contrast agents,CEUS has demonstrated increasingly prominent roles in the diagnosis and treatment of thyroid diseases.This article reviews the application progress of CEUS in the diagnosis and treatment of thyroid diseases in China from 2021 to 2024.It explores the clinical application value of CEUS in thyroid nodule diagnosis,lymph node evaluation,assessment of thyroid cancer invasiveness,and guidance for thermal ablation therapy.Additionally,it makes an outlook on the future integration of CEUS with emerging technologies such as molecular ultrasound,artificial intelligence,and robotic technology,aiming to provide new insights and approaches for the precise diagnosis and treatment of thyroid diseases. 甲状腺结节作为临床常见的内分泌系统疾病,其诊断与鉴别诊断始终是医学界的重要挑战。超声造影(CEUS)自1969年首次实现声学增强现象观测以来,历经显影剂研发(20世纪90年代)及成像算法革新(21世纪初)两大阶段逐步成熟。该技术自2003年进入中国临床实践,通过逾20年的本土化发展,其基于微循环灌注成像的特征分析能力已在良恶性结节鉴别、早期癌变筛查及个体化治疗方案制订等关键临床场景中成为动态血流评估的核心影像学工具。近年来,得益于仪器性能提升和新型造影剂涌现,CEUS在甲状腺疾病诊治领域作用凸显。本文旨在综述2021至2024年CEUS在甲状腺疾病诊治中的应用进展,探讨其在甲状腺结节诊断、淋巴结评估、甲状腺癌侵袭性评估、热消融术指导等方面的临床应用价值,并展望未来CEUS与分子超声、人工智能、机器人技术等新兴技术的融合发展趋势,以期为甲状腺疾病的精准诊疗提供新的思路和方法。.