探讨甲状腺乳头状癌（PTC）超声造影血流灌注参数与微血管密度（MVD）及微血管面积（MVA）的相关性，评估超声造影无创性评价PTC血管生成的价值。

选取2014年4月至2016年10月在青岛大学附属医院手术切除并经病理证实的PTC患者69例，按病灶大小将患者分为<1 cm组、1~2 cm组、>2.0 cm组，按颈部淋巴结病理结果将患者分为淋巴结转移组、未转移组。采用t检验（两组间）或单因素方差分析（多组间）比较各组超声造影血流灌注定量参数；对术后结节及甲状腺组织病理标本行免疫组化染色获取MVD及MVA，并与定量参数进行Spearman秩相关性分析。

（1）PTC结节峰值强度（Peak）、曲线下面积（AUC）、MVD及MVA均低于周围正常甲状腺组织（14.95±4.96 vs 22.67±6.11，970.01±263.20 vs 1798.35±563.67，118.91±31.32 vs 206.27±39.58，8.58±2.68 vs 18.47±3.13），差异均有统计学意义（t=-8.700、-11.061、-14.377、-20.532，P均<0.05）；（2）随着PTC结节增大，各组Peak及AUC、MVD及MVA依次增加，且不同大小3组结节组间两两比较，差异均有统计学意义（<1 cm组与1~2 cm组比较：t=0.000、0.000、0.000、0.000；<1 cm组与>2.0 cm组比较：t=0.027、0.044、0.033、0.000；1~2 cm组与>2.0 cm比较：t=0.027、0.044、0.033、0.000，P均<0.05）；（3）淋巴结转移组Peak、AUC、MVD及MVA值高于未转移组（16.86±4.36 vs 13.80±3.55，1128.16±290.85 vs 874.39±192.27，114.12±30.69 vs 103.67±22.19，10.30±2.44 vs 7.54±2.29），差异均有统计学意义（t=3.177、4.366、6.336、4.742，P均<0.05）；（4）相关分析结果显示，Peak、AUC与MVD呈正相关（r=0.506、0.478，P均<0.05），Peak、AUC与MVA呈正相关（r=0.648、0.653，P均<0.05）；灌注参数TP、MTT与MVD与MVA无明显相关性。

超声造影定量参数Peak、AUC在一定程度上可反映甲状腺乳头状癌的MVD与MVA，可无创性评价在体肿瘤微血管生成情况，对PTC的临床诊断及其预后的评估具有重要价值。

To explore the correlation between quantitative parameters of blood perfusion with contrast-enhanced ultrasound (CEUS) and microvessel density (MVD), microvessel area (MVA) in papillary thyroid carcinoma (PTC). And to investigate the value of CEUS in evaluating the angiogenesis in PTC before operation.

Totally 69 cases of patients with papillary thyroid carcinoma were selected from April 2014 to October 2016 in the Affiliated Hospital of Qingdao University. The CEUS characteristics of 69 patients with papillary thyroid carcinoma confirmed by pathology were retrospectively analyzed. The patients were divided into three groups according to maximum diameter of lesions (<1 cm group, 1-2 cm group and >2.0 cm group), and two groups according to pathologic reports (neck lymph node metastatic and nonmetastatic groups). The blood perfusion parameters between or among different groups were evaluated by ″t″test or one-way ANOVA. Immunohistochemical staining were performed to evaluate the MVD, MVA in the surgical specimens, and the correlation of quantitative parameters with MVD, MVA were assessed by Spearman.

(1) Peak Intensity (Peak), area under the curve (AUC), MVD and MVA of thyroid carcinoma were lower than the surrounding normal thyroid tissue (14.95±4.96 vs 22.67±6.11, 970.01±263.20 vs 1798.35±563.67, 118.91±31.32 vs 206.27±39.58, 8.58±2.68 vs 18.47±3.13), and the differences were statistically significant (t=-8.700, -11.061, -14.377 and -20.532, all P<0.05). (2)With the increase of the lesion′s maximum diameter, Peak, AUC, MVD and MVA increased, and the differences were statistically significant (t=0.000, 0.000, 0.000, 0.000; t=0.027, 0.044, 0.033, 0.000; t=0.027, 0.044, 0.033, 0.000, all P<0.05). (3) Papillary thyroid carcinoma with lymphatic involvement had significantly higher values of Peak, AUC, MVD and MVA than those without lymphatic involvement (16.86±4.36 vs 13.80±3.55, 1128.16±290.85 vs 874.39±192.27, 114.12±30.69 vs 103.67±22.19, 10.30±2.44 vs 7.54±2.29), and the differences were statistically significant (t=3.177, 4.366, 6.336 and 4.742, all P<0.05). (4) A positive correlation existed between the Peak, AUC and MVD, and the differences were statistically significant (r=0.506, 0.478, all P<0.05). Peak, AUC and MVA showed positive correlation, and the differences were statistically significant (r=0.648, 0.653, all P<0.05). TP, MTT and MVD, MVA showed no correlations (all P>0.05).

The values of Peak and AUC calculated from CEUS were correlated to MVD and MVA. CEUS may be used to evaluated the angiogenesis of PTC before operation. And CEUS is helpful for prediction of prognosis of PTC.