单发性结节性甲状腺肿和甲状腺肿瘤彩色多普勒血流显像的比较与分析

Comparative analysis of color doppler flow imaging between mono-nodular goiter and thyroid neoplasm

目的探讨彩色多普勒血流显像(CDFI)对甲状腺肿瘤及单发性结节性甲状腺肿(以下简称结甲肿)诊断的意义。方法比较49例甲状腺癌、126例甲状腺瘤和82例单发性结节甲状腺肿患者的二维及CDFI声像结果。结果(1)二维声像图:结甲肿组与甲癌组比较,其中甲状腺大小、结节大小和血流分级差异均有显著性(P<0.01),而结节内部回声、边缘晕环差异则无显著性(P>0.05);结甲肿组与腺瘤组比较,其甲状腺大小、结节内部回声差异均无显著性(P>0.05),而边缘晕环、血流分级差异则均具显著性(P<0.01)。(2)CDFI:结甲肿组与甲癌组比较,其结节内部Vmax(血流高峰值)、Vmin(血流低峰值)和RI(阻力指数)差异均有显著性(P<0.05),结节周边血流高峰值Vmax、血流低峰值Vmin差异也有显著性(P<0.001),而阻力指数RI差异无显著性(P>0.05);结甲肿组与腺瘤组比较,其结节内部血流高峰值Vmax、血流低峰值Vmin差异无显著性(P<0.05),阻力指数RI差异具显著性(P<0.01);结节周边血流高峰值Vmax、血流低峰值Vmin差异具显著性(P<0.001),阻力指数RI差异无显著性(P>0.05)。结论可以通过单发性结节甲状腺肿患者的二维及CDFI结果进行鉴别诊断。

Objective To investigate the diagnostic value of color doppler flow irnaging（CDFI）for mono-nodular goiter and thyroid neoplasm. Methods The 2-dimensional （2D） sonogram and CDFI were used to analyze 49 cases of thyroid carcinoma （TC Group）, 126 cases of thyroid adenoma （TA Group） and 82 cases of mono-nodular goiter （ NG Group）. Results （ 1 ） 2D sonogram： Between NG and TC Group, there were differences in the size of thyroid, the size of nodus and the blood flow grading, P 〈 0.01, while no difference in the nodus internal echo and borderline areola annulation, P 〉 0.05; Between NG and TA Group, there were differences in the borderline areola annulation and blood flow grading, P 〈 0.01, while no differences in the size of thyroid and the size of nodus internal echo, P 〉 0.05. （2） CDFI ： Between NG Group and TC Group, there were differences in nodus internal bloodflow maximum value （Vmax）, bloodflow minimum value （Vmin） and resistent index （RI） each with P〈 0.05, in the Vmax and Vmin on the edge of nodus each with P 〈 0. 001, while no difference in RI, P 〉 0.05; Between NG Group and TA Group, there were differences in the nodus internal Vmax and Vmin each with P〈0.05, in the RI with P〈0. 01, in the Vmax and Vmin on the edge of nodus with P 〈 0. 001, while no difference in the RI, P 〉 0.05. Conclusion Differentiated diagnosis between mono-nodular goiter and hyroid neoplasm might be possible with 2-dimensional （2D） sonograrn and CDFI examination.