甲状腺微小癌的二维超声表现及彩色多普勒血流显像特征观察

Characteristics of color Doppler ultrasound in the diagnosis of thyroid micro carcinoma

目的探讨甲状腺微小癌二维超声和彩色多普勒血流显像特征。方法选择64例甲状腺微小癌患者(91个结节)作为观察组,选择同期诊治的60例甲状腺良性结节患者(72个结节)为对照组。两组均行超声检查,比较两组二维超声及彩色多普勒血流显像特征。结果两组二维超声回声、钙化、纵横比及血流丰富情况比较,差异均有统计学意义(P<0.05);两组淋巴结肿大情况比较,差异无统计学意义(P>0.05);二维超声诊断甲状腺微小癌的灵敏度为85.71%(78/91)、特异度为88.89%(64/72)、阳性预测值为90.70%(78/86)、阴性预测值为83.12%(64/77)。与对照组比较,观察组彩色多普勒血流显像Ⅰ型、Ⅱ型比例更低,Ⅲ型比例更高,差异有统计学意义(P<0.05)。结论二维超声及彩色多普勒血流显像诊断甲状腺微小癌的准确性高,有一定的应用价值,但一些微小癌缺乏典型声像图特征或合并其他良性疾病,易造成漏误诊,需结合临床表现及其他辅助检查手段确诊。

Objective To investigate the ultrasonic diagnosis of thyroid carcinoma and the characteristics of color Doppler flow imaging and two-dimensional ultrasound imaging. Methods Totally 124 patients were admitted in our department between January 2011 to March 2015,64 cases of thyroid microcarcinoma（91 nodules） as the study group,60 cases admitted in the same period of benign thyroid nodule （72 nodules） as control group. All cases underwent uhrasonography, and two-dimensional ultrasound and color Doppler flow imaging features were compared in patients between the two groups. Results Two-dimensional ultrasonic echo, calcification, aspect ratio and abundant blood flow situation had significant difference between the two groups （ P 〈 0.05 ） , while, lymph node enlargement of no significant difference （ P 〉 0.05 ）. The sensitivity of the two-dimensional ultrasound in diagnosis of thyroid microcarcinoma was 85.71% （78/91） , the specificity was 88.89% （ 64/72 ） , positive predictive value of 90.70% （ 78/86 ） , and negative prediction value of 83.12% （64/77）. When compared with the control group, color Doppler flow imaging（CDFI） type Ⅰ , a lower proportion of type Ⅱ ,a higher proportion of type Ⅲ in the study group had statistical significances（ P 〈0.05 ）. Conclusion High accuracy of two-dimensional ultrasound and color Doppler flow imaging in diagnosis of thyroid microcarcinoma, have certain application value, but some microcarcinoma lack typical uhrasonographic features or combined with other benign diseases, easy cause misdiagnosis, should be combined with clinical manifestations and other accessorial inspection check method for diagnosis.