超声联合3D-PDA对甲状腺结节严重程度判断及临床病理分析

Ultrasound combined with 3D-PDA in diagnosis of thyroid nodules and its clinicopathological analysis

目的研究超声联合三维能量多普勒血管成像(3D-PDA)对甲状腺结节严重程度的判断及临床病理特征。方法选择2013年11月至2017年11月联勤保障部队第908医院收治的甲状腺结节患者120例,其中男性64例,女性56例;年龄38~43岁,平均年龄41.22岁;体质量指数(BMI)为(23.18±1.39) kg/m^2。良性结节患者67例,恶性结节患者53例,分别对所有患者进行彩色超声和3D-PDA检查,检查过程中,采用双盲形式。分别对超声诊断和3D-PDA诊断情况及联合检测的诊断效能进行对比观察。结果对患者的常规超声检查中,良性结节组与恶性结节组甲状腺结节血流分级(χ^2=35.231,P=0.000)、动脉收缩期最大流速(PSV)(t=11.098,P=0.000)及阻力指数(RI)(t=13.230,P=0.000)之间的差异存在显著统计学意义,相比恶性结节,良性结节血流分级较小,PSV及RI较低。良性结节患者与恶性结节患者在进行3D-PDA检查结果显示,两组甲状腺结节血流分布(χ^2=23.831,P=0.000)、血管数量(χ^2=25.132,P=0.000)、血管走行(χ^2=12.511,P=0.000)、血管空间分布(χ^2=66.641,P=0.000)、结节血流情况(χ^2=79.951,P=0.000)、周边实质组织血流情况(χ^2=19.172,P=0.000)之间的差异存在显著统计学意义;通过对超声联合3D-PDA、单独使用超声和3D-PDA对甲状腺结节的诊断效能观察,联合检测的受试者工作特性曲线下面积高于单独检测,差异存在统计学意义(P <0.05)。结论超声联合3D-PDA对甲状腺结节严重程度的判断灵敏度高于单独检测,值得在临床工作中进行推广。

Objective To study the judgment and clinicopathological features of thyroid nodules severity by ultrasound combined with three-dimensional power Doppler angiography(3 D-PDA). Methods From November 2013 to November 2017, a total of 120 patients with thyroid nodules were enrolled, which included 64 males and 56 females, aged 38-43 years old with mean age of 41.22 years old;body mass index(BMI) was(23.18 ± 1.39) kg/m^2. There were 67 patients with benign nodules and53 with malignant nodules. In double-blind method, color ultrasound and 3 D-PDA examination were performed respectively.The comparative analysis of diagnostic efficacy of ultrasound, 3 D-PDA and combined detection were performed. Results In routine ultrasound examination, there were significant differences in blood flow grading(χ^2= 35.231, P = 0.000), peak systolic velocity(PSV)(t = 11.098, P = 0.000) and resistance index(RI)(t = 13.230, P = 0.000) between benign nodule group and malignant nodule group(P < 0.05). Compared with malignant nodule group, benign patients had smaller blood flow grading and lower PSV and RI. The results of 3 D-PDA showed that there were significant differences between 2 groups in nodular blood flow distribution(χ^2= 23.831, P = 0.000), number of blood vessels(χ^2= 25.132, P = 0.000), shape of blood vessels(χ^2= 12.511, P =0.000), spatial distribution of blood vessels(χ^2= 66.641, P = 0.000), nodular blood flow(χ^2= 79.951, P = 0.000) and peripheral tissue blood flow(χ^2= 19.172, P = 0.000). The diagnostic efficacy of ultrasound combined with 3 D-PDA, ultrasound, 3 D-PDA for thyroid nodules showed that area under curve of combined detection was higher than that of single detection, and the difference was statistically significant(P < 0.05). Conclusion It is demonstrated that the sensitivity of ultrasound combined with 3 DPDA in judging severity of thyroid nodules is higher than that of single detection, which is worth popularizing in clinical.