超声微血流显像对甲状腺结节性质鉴别及对甲状腺癌血流情况判断的价值探讨

Value of ultrasoundmicroflowimaging in differentiating the nature of thyroid nodules and judging the blood flow of thyroid cancer

目的探讨超声微血流显像对甲状腺结节性质鉴别及对甲状腺癌血流情况判断的价值。方法选择2020年12月—2022年10月本院诊查的122例甲状腺结节患者作为研究对象,均行超声微血流显像检查,评价结节血流分级情况及血流分布模式分型。以病理结果为金标准,将所有甲状腺结节分为恶性组与良性组,采用受试者工作特征曲线(ROC)分析血流分级与血流模式分型对甲状腺结节性质鉴别诊断价值。结果167枚结节经手术病理检查,最终诊断为恶性结节102枚;恶性组血流检出率为97.06%,高于良性组(58.46%)(P<0.001);恶性组Alder血流分级的0级、1级占比均低于良性组(P<0.05),2级、3级占比均高于良性组(P<0.05);恶性组血流模式的Ⅰ型、Ⅱ型占比均低于良性组(P<0.05),Ⅳ型占比高于良性组(P<0.05);ROC曲线分析结果显示,血流分级与血流模式分型联合鉴别诊断甲状腺结节性质的灵敏度、特异度和曲线下面积(AUC)分别为86.27%、81.54%和0.870,其灵敏度和AUC均高于二者单独诊断(P<0.05)。结论超声微血流显像在甲状腺结节性质鉴别及对甲状腺癌血流情况判断方面均有确切应用价值。

Objective To investigate the value of ultrasound micro blood flow imagingin differentiating the nature of thyroid nodules and judging the blood flow of thyroid cancer.Methods 122 patients with thyroid nodules those received diagnosed in our hospital from December 2020 to October 2022 were selected as research objects.All patients underwent the examination by ultrasound micro blood flow imaging,and the blood flow grading and blood flow distribution patterns of the nodules were evaluated.Taking the pathology results as the gold standard,all patients suffered from thyroid nodules were divided into malignant group and benign group.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of blood flow classification and blood flow pattern classification in the differentialof thyroid nodule nature.Results 102 out of the 167 nodules were finally diagnosed as malignant nodules according to surgical and pathological examination.The detection rate of blood flow in malignant group was 97.06%,which was higher than 58.46%of benign group(P<0.001).The proportions of Alder blood flow classification grade 0 and grade 1 in the malignant group were lower than those in the benign group(P<0.05),but the proportion of grade 2 and grade 3 were higher than those in the benign group(P<0.05).The proportion of type I and typeⅡblood flow pattern in malignant group were lower than those in benign group(P<0.05),but the proportion of typeⅣblood flow pattern in malignant group was higher than that in benign group(P<0.05).ROC analysis showed that the sensitivity,specificity and area under curve(AUC)of the combination of blood flow classification and blood flow pattern classification in differentiating the nature of thyroid noduleswere 86.27%,81.54%and 0.870 respectively,and the sensitivity and AUC of combination of the two parameters were higher than use alone(P<0.05).Conclusions Ultrasound micro blood flow imaging has definite application value in distinguishing the nature of thyroid nodules and judging the blood flow of thyroid cancer.