彩色多普勒超声诊断甲状腺微小癌

Color Doppler ultrasound in diagnosis of thyroid microcarcinoma

目的探讨高频彩色多普勒超声诊断甲状腺微小癌(TMC)的价值。方法选取经术后病理证实的TMC患者38例共42个病灶(TMC组),分析其声像图特征,包括肿块的内部回声、边缘特征、血流分布、峰值血流速度(PSV)、阻力指数(RI)及血流频谱形态。选择30例病灶≤1.0cm×1.0cm且有相似声像图特征的良性病变患者作为对照组。结果 TMC和甲状腺良性病灶的PSV及RI分别为(35.67±15.19)cm/s、0.67±0.12及(30.17±13.70)cm/s、0.64±0.06,二者差异均无统计学意义(P均>0.05)。边缘毛刺、纵横比>1、微钙化及内部血流类型在TMC和良性病变间的差异均有统计学意义(P均<0.005)。超声诊断TMC的准确率、敏感度及特异度分别为87.50%、88.10%及86.67%,阳性预测值和阴性预测值分别为90.24%和83.87%。结论高频彩色多普勒超声对诊断TMC有重要价值。

Objective To explore the value of high frequency color Doppler ultrasound in diagnosis of thyroid microcarcinoma （TMC）. Methods To analyze the sonographic characteristics of the 38 patients （42 focuses of TMC,TMC group）,including the internal echo,peripheral features,blood distribution,the peak systolic velocity （PSV）,resistance index （RI） and blood spectral patterns. Thirty patients with tumor size ≤1.0 cm×1.0 cm with similar sonographic features of benign thyroid lesions were selected as control group. All patients were confirmed with pathology. Results PSV,RI of TMC and benign thyroid lesions were （35.67±15.19）cm/s,0.67±0.12 and （30.17±13.70）cm/s,0.64±0.06 respectively （all P0.05）. There were statistically difference in edge burr,vertical/horizontal ratio 1,microcalcification and internal flow between TMC and benign thyroid lesions. Accuracy,specificity and sensitivity of ultrasound diagnosis of TMC were 87.50%,86.67% and 88.10%,respectively. Positive predictive value and negative predictive values were 90.24% and 83.87% respectively. Conclusion High frequency color Doppler ultrasound plays an important role in the diagnosis of TMC.