高频彩超对甲状腺结节良恶性的鉴别诊断价值

The value of high frequency color Doppler ultrasound on the differentiation of benign and malignant thyroid nodules

目的探讨高频彩超在鉴别甲状腺结节良、恶性方面的价值,为进一步量化评估甲状腺结节奠定基础。方法以甲状腺手术病理活检或细针穿刺抽吸活检(fine needle aspiration biopsy,FNAB)结果为"金标准",分析204例患者285个甲状腺结节的高频彩超声学特点,从甲状腺实质回声、结节回声类型、形态、边界、纵横比、与甲状腺被膜的关系、结节内是否钙化及钙化类型、声晕、结节血流分布特征及颈部淋巴结情况等方面进行评估,计算每项超声指标的比值比(OR)。结果 OR值大于1的危险因素包括甲状腺实质回声异常、形态不规则、边界不清、纵横比≥1、甲状腺被膜侵犯、无声晕或声晕不完整、不均匀者、微钙化灶及颈部淋巴结转移。结论甲状腺实质回声异常、形态不规则、边界不清、纵横比≥1、无声晕或声晕不完整、不均匀者、微钙化灶及颈部淋巴结转移可作为鉴别甲状腺良、恶性的声学特点。

Objective To evaluate the value of high frequency color Doppler ultrasound in the differentiation of be- nign and malignant thyroid nodules. Methods 204 cases of thyroid nodules （n=285） confirmed by surgical pathology or FNAB were underwent color Doppler ultrasound. All nodules were evaluated from thyroid echo. The echo type of nodule, shape, border,A/T, the relationship with thyroid capsule, the type of calcification, acoustic halo, blood flow distribution and the metastatic condition of cervical lymph nodes. OR of every ultrasonic index was calculated. Results The ORs of thyroid echo, irregular shape, vague margin, A/T≥1, coated capsule, incomplete acoustic halo, microcalcification and metastatic cervical lymph nodes were all greater than 1. Conclusion The thyroid echo,irregular shape,vague margin, A/T 31,coated capsule,incomplete acoustic halo, microcalcification and metastatic cervical lymph nodes are valuable on the differentiation of benign and malignant thyroid nodules.