结节性甲状腺肿和甲状腺腺瘤超声鉴别诊断研究

The Ultrasonography on the differential Diagnosis of Nodular Goiter and Thyroid Adenoma

目的分析超声对结节性甲状腺肿、甲状腺腺瘤的鉴别诊断价值。方法回顾性分析2020年1月至2022年12月开封一五五医院收治的90例病理检查确诊甲状腺疾病患者的临床资料,依据病理结果分成A组(甲状腺腺瘤)46例和B组(结节性甲状腺肿)44例,两组均开展二维超声和彩超检查。比较两组确诊率、超声图像特征和收缩期流速峰值(Vmax)、舒张末期流速最低值(Vmin)及阻力指数差异。结果两组确诊率比较,差异无统计学意义(P>0.05)。两组结节大小、结节中回声比较,差异无统计学意义(P>0.05);但A组双叶甲状腺肿大、单发结节、有晕环、有包膜比例均高于B组,差异有统计学意义(P<0.05)。A组Ⅱ级、Ⅲ级血流占比和脉冲多普勒显示的Vmax高于B组,阻力指数低于B组,差异有统计学意义(P<0.05)。结论超声能对结节性甲状腺肿、甲状腺腺瘤做出准确鉴别诊断,结合超声图像特征和血流参数等能给临床诊断和治疗带来重要参考依据,有着较高的临床应用价值。

Objective Retrospective analysis was made on the clinical data of 90 patients with Thyroid disease diagnosed by pathology in Kaifeng 155 Hospital from 2020.1 to 2022.12.According to the pathological results,46 cases were divided into group A(thyroid adenoma)and 44 cases into group B(nodular goiter).The two-dimensional ultrasonography and color Doppler ultrasonography were performed in both groups.Group contrast results were concluded through the diagnosis accuracy,ultrasonic features,peak systolic velocity(Vmax),end-diastolic minimal velocity(Vmin)and resistance index.Results The diagnosis accuracy between groups was not significantly different(P>0.05);the nodule size and nodular echo between groups were not significantly different(P>0.05);the incidences of thyroid enlargement,solitary nodule,aureole and envelope in group A were significantly higher than group B(P<0.05);the blood flow signal grading,gradeⅡand grade III blood flow ratios and Vmax values in group A were higher than group B(P<0.05);the resistance index in group A was lower than group B,and the difference was statistically significant(P<0.05).Conclusion Ultrasound can make accurate differential diagnosis of nodular Goitre and thyroid adenoma.Combining with ultrasonic image characteristics and blood flow parameters,it can provide important reference for clinical diagnosis and treatment,and has high clinical application value.