彩色多普勒超声在甲状腺良恶性结节鉴别诊断中的应用价值探讨

Color Doppler ultrasound in the differential diagnosis benign and malignant thyroid nodules

目的 探讨彩色多普勒超声在甲状腺良恶性结节鉴别诊断中的应用价值.方法 选择2011年12月～2013年12月在我院住院治疗的甲状腺结节患者50例,应用彩超对比良恶性结节的大小、位置、形态及回声特点.然后采用CDFI观察结节内部及周边血流情况,测量收缩期峰值流速（Vmax）和阻力指数（RI）、Adler分级.结果 甲状腺结节患者50例中甲状腺癌6例,结节性甲状腺肿12例,甲状腺腺瘤32例.良性结节组的形态规则比率、边界清晰比率、有晕环比率、囊实性比率分别明显高于恶性结节组（P＜0.05）.且良性结节组微小钙化比率明显低于恶性结节组（P＜0.05）.而恶性结节组的血流信号丰富比率明显高于良性结节组（P＜0.05）.良性结节组RI明显低于恶性结节组（P＜0.05）.但两组的低回声比率、Vmax值比较,差异无显著性（P＞0.05）.其中良性结节组的血流分级以0～Ⅰ级为主,而恶性结节组的血流分级以Ⅱ～Ⅲ级为主.结论 彩色多普勒超声对于鉴别甲状腺良恶性结节具有重要的临床价值.

Objective To evaluate the differential diagnosis value of color Doppler ultrasound in benign and malignant thyroid nodules. Methods Fifty cases thyroid nodules treated by the application Color Doppler ultrasound,the benign and malignant nodules , location, shape and echo Characteristics were compared. The blood flow and around the nod- ule, Vmax and RI, Adler classification were compared by CDFI. Results Thyroid nodules in 50 patients with thyroid cancer in 6 cases, 12 cases of nodular goiter , thyroid adenoma in 32 cases. Morphological rules ratio benign nodules group demarcated ratio , the ratio has a halo , cystic ratios were significantly higher than malignant nodules group （P 〈0.05）. Microcalcifications and benign nodules group was significantly lower than the ratio of malignant nodules group （P〈0.05）. And malignant nodules rich blood flow signal ratio was significantly higher than benign nodules group （P〈 0.05）. Benign nodules was significantly lower than malignant nodules RI group （P〈O.05）. But two hypoeehoic ratio, Vmax values, the difference was not statistically significant（P〉 0.05）. Benign nodules group flow grade 0-1 to Class - based, while the flow grade malignant nodules in the group II-III level based. Conclusion Color Doppler ultrasound for the identification of benign and malignant thyroid nodules has important clinical value.