彩色多普勒超声在甲状腺癌及结节性甲状腺肿中的鉴别诊断价值及血流信号分析

The value of color Doppler ultrasound in the differential diagnosis of thyroid cancer and nodular goiter and the analysis of blood flow signals

目的:探讨彩色多普勒超声在甲状腺癌、结节性甲状腺肿中的鉴别诊断价值及血流信号分析。方法:回顾性分析东营区人民医院2021年3月—2023年3月收治的125例甲状腺肿物患者临床资料,其中52例为甲状腺癌,73例为结节性甲状腺肿。所有患者均行彩色多普勒超声检查,以病理检查结果为金标准,分析彩色多普勒超声鉴别诊断效能;采用Kappa检验验证彩色多普勒超声与病理检查的一致性;比较甲状腺癌与结节性甲状腺肿血流信号分布。结果:125例甲状腺肿物患者经彩色多普勒超声检出甲状腺癌50例,结节性甲状腺肿75例;彩色多普勒超声鉴别诊断灵敏度为94.23%(49/52)、特异度为98.63%(72/73)、准确率为96.80%(121/125)、阳性预测值为98.00%(49/50)、阴性预测值为96.00%(72/75);彩色多普勒超声鉴别诊断与病理检查一致性极好(Kappa值=0.934)。甲状腺癌患者血流信号丰富程度高于结节性甲状腺肿,差异有统计学意义(P<0.05)。结论:彩色多普勒超声在鉴别诊断甲状腺癌与结节性甲状腺肿中具有较高价值,且与病理检查一致性高,便于早期明确疾病诊断,从而开展针对性治疗。

Objective To investigate the value of color Doppler ultrasound in the differential diagnosis of thyroid carcinoma and nodular goiter and the analysis of blood flow signal.Methods Clinical data of 125 patients with goiter admitted to Dongying District People's Hospital from March 2021 to March 2023 were retrospectively analyzed,including 52 patients with thyroid cancer and 73 patients with nodular goiter.All patients underwent color Doppler ultrasonography,and pathological examination result was used as the gold standard to analyze the differential diagnosis efficiency of color Doppler ultrasonography.Kappa test was used to verify the consistency between color Doppler ultrasound and pathological examination,and to compare the distribution of blood flow signal between thyroid carcinoma and nodular goiter.Results In 125 patients with goiter,50 cases of thyroid cancer and 75 cases of nodular goiter were detected by color Doppler ultrasound.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of color Doppler ultrasound were 94.23%(49/52),98.63%(72/73),96.80%(121/125),98.00%(49/50)and 96.00%(72/75)respectively.The differential diagnosis of color Doppler ultrasound was very consistent with pathological examination(Kappa value=0.934).The richness of blood flow signal in thyroid cancer patients was higher than that in nodular goiter,and the difference was statistically significant(P<0.05).Conclusion Color Doppler ultrasound has high value in the differential diagnosis of thyroid cancer and nodular goiter,and has high consistency with pathological examination,which was convenient for early diagnosis of disease and targeted treatment.