高频和彩色多普勒超声对甲状腺结节病变性质鉴别诊断的价值

Value of high-frequency and color Doppler ultrasound in differential diagnosis of thyroid nodules

目的探讨高频和彩色多普勒超声对甲状腺结节病变性质鉴别诊断的价值。方法回顾性分析68例甲状腺结节手术患者临床资料。病理诊断良性结节39例(A组),恶性结节29例(B组)。比较两组高频和彩色多普勒超声特征。结果 A组甲状腺结节多表现为边界清晰、少见微钙化、无及欠完整声晕、后方回声不变或增强、有多种回声表现、多见血流分布0-Ⅰ级、阻力指数(RI)及似圆度均低。B组则多表现为结节边界欠清、多见微钙化、有声晕、后方回声衰竭增多、少见无回声、多见血流分布Ⅱ-Ⅲ级、RI及似圆度均高的特点。Logistic回归分析显示,微钙化、声晕、血流分布和似圆度可作为判断甲状腺结节的主要指标(P<0.05)。结论高频和彩色多普勒超声检查可从结节微钙化、声晕、血流分布和似圆度等特征鉴别甲状腺结节的良恶性。

Objective To investigate the value of high-frequency and color Doppler ultrasound in differential diagnosis of thyroid nodules. Methods Data of 68 cases with thyroid nodules were retrospectively analyzed. The patients were diagnosed pathologically as benign thyroid nodules （group A） in 39 cases and malignant nodules （group B） in 29 cases. The characteristics of the thyroid nodules on high-frequercy and color Doppler ultrasound were compared between two groups; Results The characteristics of benign thyroid nodules included clear boundaries, rare microcalcifications, no sound and less complete halo, posterior acoustic unchanged or enhanced, more common blood flow distribution classifications of 0-I, and lower resistance index（RI） and circularity degrees. The characteristics of malignant thyroid nodules included less clear boundaries, common microcalcifications, audio halo, increased posterior echo failure, no echo, more common blood flow distribution classifications of ]1-Ill. The differences in the features mentioned above were statistically significant between two groups （P〈0. 05 ）. Logistic regression analysis showed that microcalcifications,acoustic halo, blood flow distribution and roundness could be taken as the main indicators for differentiating benign thyroid nodules from malignant thyroid nodules （P〈0. 05 ）. Conclusion The examination with-high frequency and color Doppler ultrasound is valuable in differentiating benign thyroid noduleg from malignant ones according to different characteristics of microcalcifications, acoustic halo, blood flow distribution and roundness.