彩色多普勒超声诊断甲状腺癌的再探讨

The study on diagnosis of thyroid carcinoma by color Doppler ultrasound

目的进一步探讨甲状腺肿块超声显像的灰阶和彩色多普勒特征,寻求鉴别甲状腺良恶性肿块有价值的检测参数及其价值。方法甲状腺癌和良性肿块患者各36例,二维和彩色超声检查重点分析甲状腺肿块内部和边缘回声特点、血流分布特征、阻力指数及血流频谱形态。结果低回声、无包膜、内部微钙化及后方回声衰减四项指标对诊断甲状腺恶性肿块有较重要的意义。Ⅲ级血流信号、多普勒血流高阻或同时存在低阻、频谱多普勒收缩期峰值前移、升降波陡直以及舒张期无血流或出现反向血流等现象为恶性肿块较特异的征象。本组4例较小的恶性肿块内部无或仅有少量血流信号,但周围出现"血流汇聚"现象。结论高频彩色多普勒超声对甲状腺癌的诊断具有重要价值。

Objective To explore the gray - scale and color Doppler ultrasonic imaging characteristics of thyroid nodules, and to find significant parameters for differential diagnosis of benign and malignant thyroid nodules. Methods Thirty - six patients with thyroid carcinoma and 36 patients with benign thyroid tumors were selected. The grey- scale and color Doppler ultrasound were performed to analyze the internal and edge echo characteristics, vascularity features, resistance index（RI） and the blood spectral patterns. Results The low echo - level, no amicula, internal microcalcifications and posterior echo attenuation had important significance in the diagnosis of thyroid carcinoma.The special signs of malignant thyroid nodules were grade Ⅲ color flow; RI 〉 0.65, or together with RI 〈 0.50; spectral Doppler showed that the peak systolic velocity often appeared quickly with sharp ascending and descending slopes, there was often no or reverse flow in diastolic period. Four microcarcinomas appeared to have no or little internal color flow signals but there was affluent peripheral color flow signals concentrating to lesions. Conclusion High fequency ultrasonography has great value for diagnosis of thyroid carcinoma