甲状腺滤泡状腺癌与良性结节的超声鉴别诊断

Ultrasonographic differential diagnosis of follicular thyroid carcinoma and thyroid benign nodule

目的回顾性分析甲状腺滤泡状腺癌(FTC)与甲状腺良性结节(TBN)声像图差异性,探讨超声检查对二者的鉴别诊断价值。方法入组经手术获得明确病理诊断的48个甲状腺结节(FTC 20个,TNB 28个),回顾性分析48个结节声像图,包括二维灰阶图(结节内部回声、边缘形态、声晕情况、边界)、彩色多普勒血流分型及多普勒血流阻力指数(RI)、超声造影,采用非参数Mann-Whitney U检验比较FTC与TNB二维声像图和多普勒血流分型;采用两独立样本t检验比较血流阻力指数及超声造影定量参数;采用χ^(2)检验比较造影前后病灶大小改变。结果FTC与TBN结节内部回声、结节边缘形态、声晕情况、边界、血流RI、造影定量参数、造影后病灶是否增大等,比较具有统计学意义(U=401.50、128.00、26.00、146.00;t=3.98、5.86、3.22、4.39、7.16;χ^(2)=15.67,P值均<0.05);彩色多普勒血流分型比较差异,无统计学意义(U=260.00,P=0.66)。结论结节内部回声、边缘形态、声晕情况、边界、血流阻力指数RI、超声造影等对FTC与TBN鉴别诊断具有重要价值。

Objective The ultrasonographic difference between follicular thyroid carcinoma(FTC)and thyroid benign nodule(TBN)was analyzed retrospectively to explore the value of ultrasonography in the differential diagnosis of FTC and FTA.Methods Forty-eight thyroid nodules(20 FTC and 28 TBN)with definite pathological diagnosis were obtained by operation.The ultrasonograms of 48 nodules were retrospectively analyzed.including two-dimensional ultrasonograms(internal echo of nodules,nodular marginal morphology,ultrasonic halo,boundary),color Doppler blood flow typing and Doppler blood flow resistance index(RI),contrast-enhanced ultrasound.Non-parametric Mann-Whitney U test was used to compare FTC and FTA two-dimensional ultrasonograms and Doppler blood flow typing.Two independent sample t-test was used to compare Doppler blood flow resistance index RI and quantitative parameters of contrast-enhanced ultrasound.Chi-square test was used to compare lesion size changed before and after contrast-enhanced ultrasound.Results The difference of nodule internal echo,nodular marginal morphology,ultrasonic halo,boundary,Doppler blood flow RI,quantitative parameters of contrast-enhanced ultrasound and whether the lesion size changed before and after contrast-enhanced ultrasound was in FTC and TBN was statistically significant(U=401.50、128.00、26.00、146.00;t=3.98、5.86、3.22、4.39、7.16;χ^(2)=15.67,P<0.05).There was no significant difference and no statistical significance(U=260.0,P=0.66)in color Doppler blood flow typing.Conclusion The internal echo of nodules,nodular marginal morphology,ultrasonic halo,boundary,Doppler blood flow resistance index RI and contrast-enhanced ultrasound have important value for the differential diagnosis of FTC and TBN.