甲状腺良、恶性结节的多普勒超声检查结果分析

Value of Doppler ultrasonography in the diagnosis of benign and malignant thyroid nodules

目的分析甲状腺良、恶性结节的多普勒超声检查结果,为其初步鉴别诊断提供临床指导。方法选择2015年4月至2016年4月在阳春市中医院进行甲状腺多普勒超声检查的398例甲状腺疾病患者,通过多勒普超声检查分析其结节个数、体积和回声情况,以临床病理诊断为金标准,比较甲状腺良恶性结节的血流情况。结果 398例甲状腺疾病患者经临床病理诊断,良性结节339例,恶性结节59例;良性结节体积直径大多数≤2 cm,边界清晰且规则、无钙化、结节内部呈高回声或等回声、内部周边无血液情况,与恶性结节相比差异均有统计学意义(P<0.05);甲状腺多普勒超声诊断甲状腺囊肿、结节性甲状腺肿、甲状腺瘤和甲状腺癌结果和病理诊断结果符合率分别为92.80%(116/125)、95.16%(62/59)、97.63%(165/169)、96.08%(49/51);339例良性结节中Ⅰ型血流163例,Ⅱ型血流145例,Ⅲ型血流27例,Ⅳ型血流4例;59例恶性结节中Ⅰ型血流9例,Ⅱ型血流7例,Ⅲ型血流31例,Ⅳ型血流12例,组间比较差异有统计学意义(P<0.05)。结论甲状腺多普勒超声可清晰地检查出甲状腺结节内部结构、特征和性质,从而能准确鉴别甲状腺良性结节和恶性结节,效果显著。

Objective To analyze the Doppler ultrasound results of benign and malignant thyroid nodules,and to provide clinical guidance for the primary differential diagnosis. Methods A total of 398 patients with thyroid disease, who admitted to Yangchun Traditional Chinese Medicine Hospital from April 2015 to April 2016, were selected as research objects. The number, volume and echo of nodules were analyzed by Doppler ultrasonography. The blood flow of benign and malignant thyroid nodules was compared with the clinical pathological diagnosis as the gold standard. Results Among the 398 cases of thyroid disease, 339 cases of benign nodules and 59 cases of malignant nodules were confirmed by clinical pathological diagnosis. Compared with malignant nodules, benign nodules had the characters of volume diameter of ≤ 2 cm（mostly）, clear and regular boundary, no calcification, high echo or echo in internal nodular, and no blood around the interior（P0.05）. The coincidence rate of ultrasonography and pathological diagnosis was92.80%（116/125） for thyroid cyst, 95.16%（62/59） for nodular goiter, 97.63%（165/169） for thyroid tumor, 96.08%（49/51） for thyroid carcinoma. Among the 339 benign nodules, there were 163 cases of type Ⅰ blood flow, 145 cases of type Ⅱ blood flow, 27 cases of type Ⅲ blood flow, and 4 cases of Ⅳ type blood flow; among the 59 cases of malignant nodules, there were 9 cases of type Ⅰ blood flow, 7 cases of type Ⅱ blood flow, 31 cases of Ⅲ type blood flow, and 12 cases of type Ⅳ blood flow; the differences between the two groups were statistically significant（P0.05）. Conclusion Doppler ultrasonography results of thyroid can clearly detect the internal structure, characteristics and properties of thyroid nodules, which has the remarkable effect in the differential diagnosis of benign nodules and malignant nodules of thyroid. It is worthy of promoting.