彩色多普勒超声在甲状腺滤泡状结节鉴别诊断中的价值

Value of color Doppler ultrasound in differential diagnosis of thyroid follicular lesions

目的评价彩色多普勒超声在甲状腺滤泡状结节术前鉴别诊断中的价值。方法甲状腺单发结节患者155例,其中腺瘤89例,滤泡状腺瘤44例,滤泡状癌22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、搏动指数及血流频谱形态。结果内部回声杂乱、内部微钙化两种征象对诊断甲状腺滤泡状癌有较重要的意义。3级、4级血流信号,舒张期血流速度减低,以及PI>1.0是甲状腺滤泡状癌较特异的指标,其诊断的敏感性为88.9%,特异性为74.2%,准确性为81.0%。结论彩色多普勒超声对甲状腺滤泡状结节术前鉴别诊断具有重要价值。

Objective To evaluate the value of color Doppler ultrasound in differential diagnosis of thyroid follicular lesions. Methods One hundred and fifty-five patients with solitary nodule in the thyroid gland were selected, 89 cases of those were adenoma, 44 cases were follicular adenoma, and 22 cases were follicular carcinoma. Then the internal and edge echo characteristics, vascular features, pulsatility index （PI） and the blood spectral patterns were analyzed by two-dimensional ultrasound and color Doppler ultrasound. Results The heterogeneous internal eeho and internal mierocalcifieations had important significance in the diagnosis of thyroid follicular carcinoma. The special signs of thyroid follicular carcinoma were grade 3, grade 4 blood signals, decreased blood flow velocity in diastolic phase and PI 〉 1.0, the sensibility, specificity and accuracy were 88.9% ,74.2% and 81.0% , respectively. Conclusion Color Doppler ultrasound has important value in differential diagnosis of thyroid follicular lesions.