高频超声对结节性甲状腺肿良、恶性结节的鉴别诊断价值

Differential Diagnosis of Benign and Malignant Nodules in Nodular Goiter： The Applied Value of high-frequency

目的通过对结节性甲状腺肿（Nodular Goiter，NG）良、恶性结节超声图像特征的回顾性总结分析，探讨高频超声这一简便、无创的检测技术对NG良、恶性结节的鉴别诊断价值。方法所有30例研究对象均为我院普外科甲状腺手术病人，术前经超声检查提示有结节性甲状腺肿合并部分结节恶变可能，并经术后病理证实。每例选取其良、恶性结节各1枚，回顾性总结分析其术前超声图像特征。结果1．NG良、恶性结节的二维声像图中在边界、形态、内部回声以及“沙砾”样钙化的发生率等征象均具有统计学意义（均P〈0．005），而二者之间结节大小的比较其差异性无统计学意义（P〉0．05）。2．NG恶性结节的动脉血流阻力指数（RI）高于良性结节，二者比较其差异性具有统计学意义（P〈0．01），而二者之间动脉血流最大流速（Vmax）比较其差异性并无统计学意义（P〉0．05）。3．NG良、恶性结节的血流分布比较其差异性有统计学意义（P〈0．01）。结论结节性甲状腺肿良、恶性结节各具超声影像特征，应用高频超声这种简便、无创的检测技术，可以对活体甲状腺结节的良恶性进行较准确判断，从而对临床确定治疗方案、选择术式、判断预后等提供有价值的信息。

Objective： To discuss the value of high-frequency ultrasound which is convenient and noninvasive in differential diagnosing benign and malignant nodules in nodular goiter （NG） by analyzing ultrasonic features of benign and malignant nodules in NG retrospectively. Method： All the 30 patients were diagnosed by ultrasonography to have NG and some of the nodules may be malignant before taken in hospital to have surgery and the nodules were confirmed to be benign or malignant by pathology. One benign nodule and one malignant nodule in each patient were chosen to be analyzed the features of ultrasonography retrospectively. Results： 1. There is significant difference between benign and malignant nodules in two-dimension ultrasonography including the features of border, shape, echo and the incidence of sandy calcification （P〈0.05）, but no difference in the size of the nodules （P〉0.05） . 2. There is significant difference in resistive index （P〈0.01） and resistive index in malignant nodule is higher than in benign one, but no difference in maximum velocity of the nodule＇s artery （P〉0.05） . 3. There is significant difference between benign and malignant nodules in blood flow distribution （P〈0.01） . Conclusion： There are different ultrasonic features in benign and malignant nodules in NG. High-frequency ultrasound which is convenient and noninvasive can judge whether the nodules are benign or not in NG accurately. Thus it can provide valuable information for surgeons to determine treatment plan, choose surgical procedures and judge prognosis.