甲状腺癌137例彩色多普勒血流特征分析

A Study on Characteristics of Color Doppler Ultrasound in 137 Patients with Thyroid Carcinoma

目的探讨甲状腺癌彩色多普勒血流特征。方法对我院术后病理检查确诊的137例146个甲状腺癌病灶术前彩色多普勒血流特征进行回顾性总结分析。结果 146个甲状腺癌病灶中血流检出率为91.10%,其中周边型血流占26.03%,内部型血流占42.47%,穿入型血流占22.60%;血流分级0级8.90%,Ⅰ级34.93%,Ⅱ级37.67%,Ⅲ级18.49%。甲状腺癌病灶大小与血流分布类型和分级具有相关性,随着病灶直径增大,血流分布类型趋向于穿入型血流,血流分级逐渐增高(r=0.867,P<0.05;r=0.776,P<0.05)。随着甲状腺癌病灶直径增大,最大流速(Vmax)和阻力指数(RI)逐渐增大,不同病灶直径间Vmax和RI两两比较差异均具有统计学意义(P<0.05)。结论彩色多普勒超声检查直径>10 mm甲状腺癌随着直径增大,血流越来越丰富,血流模式趋向于杂乱,Vmax和RI逐渐增大,而直径≤10 mm甲状腺癌病灶血流不丰富。

Objective To explore characteristics of color doppler ultrasound in thyroid carcinoma. Methods The study included 137 patients with 146 malignant nodules which were confirmed by pathological diagnosis. The blood flow char-acteristics of color doppler ultrasound were retrospectively analyzed. Results Among the 146 nodules, 91. 10% showed blood flow signals, including peripheral type （26. 03%）, internal type （42. 47%） and penetration type （22. 60%）. Blood flow classifications showed that 8. 90% of the lesions were grade 0, 34. 93% were grade I, 37. 67% were gradeⅡ, and 18. 94%were grade Ⅲ. The blood flow patterns and grades were relative to the sizes of the nodule. As the sizes increased, the blood flow tended to be penetration type, and blood grade increased （r=0. 867, P〈0. 05;r=0. 776, P〈0. 05）. As the lesion si-zes increased, the Vmax and RI increased, and the differences of Vmax and RI were significant among various sizes of lesions （P〈0. 05）. Conclusion For those lesions with diameter bigger than 10 mm, blood flow is more abundant along with its size, and blood flow pattern may tend to be clutter, and Vmax and RI increase gradually. While lesions with diameter less than or equal to 10 mm may have low blood flow.