三维超声成像在甲状腺肿块良恶性鉴别诊断中的价值(附117例分析)

The three-dimensional imaging value in diagnosis of thyroid carcinoma

目的探讨三维能量成像技术及彩色多普勒血流显像技术对甲状腺肿块鉴别诊断的临床价值。方法对117例甲状腺肿块患者进行三维能量重建及彩色多普勒血流显像(CDFI)检查,全部病例均经手术病理证实。结果彩色多普勒能量图观察血流动力学研究显示甲状腺腺瘤三维能量成像血管结构呈"球形网状"结构,与腺体间存在清晰分界,仅见少量血供分支,二维图像所见"声晕"为动静脉血流。甲状腺癌多为低回声,内部结构较致密且常有"微钙化灶"的点状强回声、边界不规整;甲状腺癌三维能量成像瘤体血流灌注呈紊乱的"树枝状","树枝"可见节段性增粗现象。结论在分析甲状腺肿块三维能量成像基础上,依据肿块内部血管结构的特征,对甲状腺肿块的良恶性的判断具有重要价值。

Objective To study clinical value of the three-dimensional and color doppler flow imaging examination to thyroid cancer＇s diagnosis. Methods 86 cases with thyroid carcinoma were diagnosed by 3D and color doppler ultrasonographic examination and confirmed by operation and pathology. Results Color doppler power-graph showed that blood supply in thyroid benign tumor presented as bulb-shaped and netted structure by three-dimensional color power angio （3DCPA）. It was easy to define the tumor＇s location. Color doppler showed arterial and vein blood flow in all the tumors. Thyroid carcinoma showed hypoechogenicity, even more compact and there was often microcalcified, nodular and irregular. Conclusion The blood flow message, which based on the analyzing 3D sonogram feature of tumor, had important value to judge the character of thyroid carcinoma.