甲状腺癌的彩色多普勒血流频谱特征及其鉴别诊断价值

Characteristics of Color Doppler Ultrasonography and Its Diagnostic Value of Thyroid Carcinoma

【目的】探讨甲状腺癌结节的彩色多普勒血流频谱（CDFD特征及其鉴别诊断价值。【方法】对本院经病理学检查证实的甲状腺结节患者137例（169个结节）患者的CDFI资料进行回顾性分析，其中病理确诊甲状腺癌82例（101个结节），甲状腺良性结节55例（68个结节），比较两者的CDFI特征，并分析CDFI鉴别诊断甲状腺癌的影像学价值。【结果】甲状腺癌结节的边界模糊率为61．39％、钙化灶率76．24％、低回声率74．26％、Ⅱ～Ⅲ级血流率66．34％、阻力指数（RI）〈0．7占比62．38％、淋巴结肿大率45．54％，均高于良性结节的i6．18％、27．94％、26．47％、25．00％、35．29％、11．76％，且两者相比较差异有显著性（P〈0．05）；甲状腺癌结节出现声晕率为35．64％、后方衰减率31．68％均低于良性结节的75．OO％、55．88％，（P〈0．05）；CDFI鉴别诊断甲状腺癌结节的灵敏度为77．23％、特异度为80．88％、漏诊率为22．77％、误诊率为19．12％。【结论】甲状腺癌性结节的CDFI特征与良性结节差异显著，对于临床鉴别诊断甲状腺癌具有重要价值。

[Objective] To investigate the characteristics of color Doppler ultrasonography （CDFI） in the differential diagnosis of thyroid carcinoma. [Methods]A retrospective analysis of the CDFI data of 137 patients （169 nodules） which were confirmed by pathological examination in our hospital. Among them, there were 82 cases （101 nodules） of thyroid carcinoma and 55 patients （68 nodules） with benign thyroid nodules. CDFI fea- tures of thyroid carcinoma nodules and benign nodules were compared to reveal its diagnostic value to identify benign and malignant nodules.[Results]The rate of nodal fuzzy boundaries, calcification rate, low echo rate, grade Ⅱ- Ⅲ blood flow rate, rate of resistance index （RI）〈0.7, lymph node enlargement rate were 61.39 %, 76.24%, 74.26%, 66.34%, 62.38M, 45.54%, respectively, in thyroid cancer nodules. These were higher than those of the benign nodules 16.18%, 27.94%, 26.47%, 25%, 35.29%, 11.76%, respectively. The differences were statistically significant （ P〈0.05）. Thyroid cancer nodules appeared 35.64% of halo rate and 31.68% of rear attenuation rate, which were lower than those of benign nodules （75 %, 55.88%, respectively） and the difference was statistically significant （ P 〈0.05）. The sensitivity of CDFI in differential diagnosis of thyroid cancer nodules was 77.23%, the specificity was 80.88%, and the missed diagnosis rate was 22.77%, the misdiagnosis rate was 19.12%.[Conclusion]There are significant differences in CDFI features between be- nign and malignant thyroid nodules, which is of great value in the differential diagnosis of thyroid carcinoma.