彩色多普勒超声检查在甲状腺结节中的诊断价值

The diagnostic value of color doppler ultrasonography in the diagnosis of benign and malignant thyroid nodules

目的探讨彩色多普勒超声检查在鉴别甲状腺结节良恶性中的诊断价值。方法选取笔者所在医院超声科2014年6月~2016年12月收治的126例甲状腺结节患者作为研究对象,所有患者术前均行彩色多普勒超声诊断,术后经病理确诊,其中良性肿瘤(良性组)85例,包括甲状腺瘤51例,甲状腺肿34例;甲状腺癌(恶性组)41例。比较两组超声诊断符合率,观察患者甲状腺结节的彩色超声检查图像结果。记录血流阻力指数(RI)、舒张末期血流速度(EDV)、收缩期峰值血流速度(PSV)。结果经彩色多普勒超声检查,甲状腺良性结节超声诊断符合率为87.06%,甲状腺恶性结节超声诊断符合率为85.37%,两组比较差异无统计学意义(P>0.05),恶性组在纵径/横径、边界形态不规则、低回声、钙化比例均显著高于良性组,具有显著差异(P<0.05)。比较两组彩色多普勒超声血流分布,恶性组PSV、RI均明显高于良性组患者,而EDV则显著低于良性组,差异均有统计学意义(P<0.05)。结论彩色多谱勒超声检查是一种高效、无创,可反复性高的检查,通过对甲状腺结节的超声图像特征的分析,其对甲状腺结节的良恶性的鉴别诊断有一定的临床价值,值得临床推广应用。

Objective To investigate the value of color doppler ultrasonography in the differential diagnosis of benign and malignant thyroid nodules.Methods126patients with thyroid nodules admitted to the department of ultrasound in our hospital from June2014to December2016were selected as the subjects.They were pathologically diagnosed,including85cases of benign tumors(the benign group,with51cases of thyroid adenoma and34cases of goiter),and41cases of thyroid cancer(the malignant group).The diagnostic accuracy of the two groups was compared.The location,shape,size,border,internal echo,micro calcification and blood flow distribution of the thyroid nodules were observed.The blood pressure resistance index(RI),end diastolic blood flow velocity(EDV)and systolic peak blood flow velocity(PSV)were recorded.Results the diagnostic accuracy rate of ultrasonography in thyroid benign nodules was87.06%by color Doppler ultrasonography.The coincidence rate of ultrasound diagnosis of thyroid malignant nodules was85.37.The difference between the two groups was not statistically significant(P>0.05).The malignant group was significantly higher than the benign group in longitudinal diameter/transverse diameter,irregular border shape,low echo and calcification,with significant difference(P<0.05).PSV and RI of malignant group were significantly higher than those of the benign group,while EDV was significantly lower than that of the benign group,and the differences were statistically significant(P<0.05).Conclusion Color Doppler ultrasonography is an noninvasive,high efficiency,high repeatability check.Through the analysis of features of thyroid nodules lesion shape,edge shape,calcification and blood flow spectrum of ultrasound images,it has certain clinical value of benign and malignant thyroid nodules differential diagnosis,it is worthy of clinical application.