超声彩色多普勒“血管汇聚征”鉴别甲状腺良恶性肿物

Retraction phenomenon on CDFI in diagnosis of benign and malignant thyroid masses

目的探讨采用CDFI"血管汇聚征"鉴别甲状腺肿物良恶性的价值。方法收集经病理证实的65例(102个结节)甲状腺肿物患者,其中恶性组36例(结节54个),良性组29例(结节48个)。于灰阶声像图上观察肿物的形态、边缘、回声级别、有无钙化灶等特征,记录肿物的大小及纵横比;采用CDFI观察肿物有无"血管汇聚征"。分析良、恶性组间各个征像分布的差异。结果 40.74%(22/54)的甲状腺恶性结节可见"血管汇聚征";95.65%(22/23)具有"血管汇聚征"的结节为甲状腺恶性结节。对甲状腺恶性肿物诊断意义较大的征象为:1实性肿物,2微小钙化,3后方衰减,4血管汇聚征。当1+2+3时,诊断甲状腺癌的敏感度和特异度为79.63%(43/54)和93.75%(45/48),当1+2+3+4时,诊断甲状腺癌的敏感度和特异度为87.04%(47/54)及93.75%(45/48)。结论 CDFI上"血管汇聚征"的出现可提示甲状腺肿物为恶性肿瘤。

Objective To evaluate the value of retraction phenomenon on CDFI in diagnosis of benign and malignant thyroid masses.Methods Totally 65 patients with 102 thyroid masses were divided into malignant group（36patients with 54 thyroid masses）and benign group（29patients with 48 thyroid masses）according to histopathologic results.Some sonographic features of thyroid masses were observed in B-mode such as shapes,margins,microcalcifications and retraction phenomenon on CDFI mode.Size and anteroposterior diameter/transverse diameter（A/T）ratio of all masses were measured.The difference of the distribution of the features between the benign and malignant groups was statistically analyzed and compared.Results The retraction phenomenon on CDFI could be found in 40.74%（22/54）thyroid malignant nodules;95.65%（22/23）nodules of thyroid with retraction phenomenon were malignancy.Four features were significantly more frequent in malignant than that in benign nodules：1Solid appearance,2microcalcification,3posterior attenuation,4retraction phenomenon.The diagnostic sensitivity and specificity of1＋2＋3and1＋2＋3＋4 were 79.63%（43/54）,93.75%（45/48）and 87.04%（47/54）,93.75%（45/48）,respectively.Conclusion Retraction phenomenon on CDFI is useful for diagnosis of thyroid cancer.