结节性甲状腺肿和甲状腺腺瘤超声鉴别诊断临床分析

Clinical analysis of ultrasonic differential diagnosis between nodular goiter and thyroid adenoma

目的研究超声检查用于结节性甲状腺肿和甲状腺腺瘤鉴别诊断的临床效果及应用价值,以期为临床诊断提供参考。方法选取2019年6月至2021年6月万宁市人民医院收治的50例甲状腺病变患者为研究对象进行回顾性分析,患者均接受超声检查。根据穿刺病理结果分为观察组(24例,结节性甲状腺肿)和对照组(26例,甲状腺腺瘤),比较两组患者超声影像特点,记录血流动力学参数指标水平。结果观察组患者多发病灶例数显著多于对照组,晕环征和包膜征发生率显著低于对照组(P<0.05)。两组患者病灶直径、边界及内部回声表现比较,差异均无统计学意义(均P>0.05)。观察组患者血流信号以0级和Ⅰ级为主,对照组患者以Ⅱ级和Ⅲ级为主(P<0.05)。观察组患者结节内和结节周边收缩期峰值流速(Vmax)和阻力指数(RI)水平显著低于对照组,结节周边血流中舒张末期最低流速(Vmin)显著低于对照组(P<0.05)。两组患者结节内Vmin水平比较,差异无统计学意义(P>0.05)。结论超声检查可提供丰富的定量和定性指标,有助于结节性甲状腺肿和甲状腺瘤的鉴别诊断。

Objective To study the clinical effect and application value of ultrasonography in differential diagnosis of nodular goiter and thyroid adenoma,in order to provide clinical reference.Methods 50 patients with thyroid disease admitted to People’s Hospital of Wanning from June 2019 to June 2021 were selected as the research subjects for retrospective analysis,and all patients received ultrasound examination.According to the pathological results of puncture,patients were divided into observation group(24 cases,nodular goitre)and control group(26 cases,thyroid adenoma).The characteristics of ultrasound images of patients in the two groups were compared,and the levels of hemodynamic parameters were recorded.Results The number of patients with multiple lesions in the observation group was significantly higher than that in the control group,and the incidence of halo sign and capsule sign was significantly lower than that in the control group(P<0.05).There was no significant difference in lesion diameter,boundary and internal echo between the two groups(P>0.05).The blood flow signals of the observation group were mainly grade 0 andⅠ,while those of the control group were mainly gradeⅡandⅢ(P<0.05).The levels of peak systolic velocity(Vmax)and resistance index(RI)in and around the nodule in the observation group were significantly lower than those in the control group,the minimum end diastolic velocity(Vmin)in the blood flow around the nodule was significantly lower than that in the control group(P<0.05).There was no significant difference in the level of Vmin in nodules between the two groups(P>0.05).Conclusion The ultrasonography can provide abundant quantitative and qualitative indexes,which is helpful to the differential diagnosis of nodular goiter and thyroid tumor.