彩色多普勒超声在甲状腺结节良恶性诊断中的应用价值

Value of Color Doppler Ultrasonography Applied in the Diagnosis of Benign and Malignant Thy-roid Nodules

【目的】探讨彩色多普勒超声在鉴别诊断甲状腺结节良恶性中的应用价值。【方法】选取2010年1月至2012年3月应甲状腺结节在本院行手术治疗的患者80例（98个结节），术后病理检查为42个恶性结节，56个良性结节，分析各结节彩色多普勒超声图像，比较良恶性结节间纵／横比、内部钙化、血流情况等监测值差异。【结果】42个恶性结节纵／横比≥1比例为76．19％高于良性结节比例28．57％（P〈0．05）；而恶性结节多数边缘模糊，无包膜，而良性结节多数边缘清晰，有包膜；恶性结节有12个颈部淋巴结肿大，良性结节仅为2个，恶性结节出现23个细钙化，良性仅为3个，且恶性结节血流丰富，血管分布杂乱，良性结节血流相对不丰富。【结论】超声是甲状腺结节的首选影像学检查方法，彩色多普勒超声结合二维超声对鉴别甲状腺结节良恶性具有，临床应用价值，值得临床推广应用。

[Objective]To explore the value of color Doppler flow imaging（CDFI） in the differential diag- nosis of benign or malignant thyroid nodules. [Methods]Totally 80 patients with thyroid nodules undergoing the operation from Jan. 2010 to March 2012 in our hospital were chosen. Postoperative pathology results showed 43 patients were malignant nodules and 56 patients were benign nodules. CDFI of all nodules was ana- lyzed. The difference of the monitoring values such as A/T, internal calcification and flow pattern was ob- served. [Results] There were 42 malignant nodules with A/T≥（76. 19%）, which were more than benign nodules（28.57 %）（ P d0.05）. Malignant thyroid nodules showed unclear border without envelope, while be- nign thyroid nodules showed clear border with envelope. Cervical lymphadenectasis was found in 12 malignant nodules and only 2 benign nodules. Microcalcification was observed in 23 malignant nodules and only 3 benign nodules. Malignant nodules had abundant blood flow and confused vascular distribution, while benign nodules had no plentiful blood flow. [Conclusion]Ultrasonography is the first imaging method of thyroid nodules. CD- FI combined with two-dimensional sonogram is valuable in the differential diagnosis of benign or malignant thy- roid nodules. Therefore it should be worthy of clinical promotion.