彩色多普勒超声对恶性甲状腺结节及淋巴结转移的诊断价值探究

Diagnostic value of color Doppler ultrasound in malignant thyroid nodule and lymph node metastasis

目的:探讨彩色多普勒超声(彩超)对恶性甲状腺结节及淋巴结转移的诊断价值。方法:选取2021年4月至2023年4月期间本院收治的甲状腺结节患者116例为研究对象。以病理结果为“金标准”,比较彩超结果与病理结果。比较良性结节与恶性结节超声特征;比较彩超与病理诊断淋巴结转移结果;比较良性增生性淋巴结与转移性淋巴结影像学表现。结果:116例甲状腺结节患者经病理诊断恶性结节62例,良性结节54例,彩超诊断灵敏度为96.77%、特异度为96.30%、准确率为96.55%。恶性结节病灶不规则、边界不清晰、无声晕、低回声、微钙化的发生率高于良性结节(P<0.05)。62例甲状腺恶性结节患者,经超声检查共探及102枚肿大淋巴结,经病理诊断良性增生性淋巴结34枚,转移性淋巴结68枚,超声诊断灵敏度为79.41%、特异度为88.24%、准确率为82.35%。转移性淋巴结L/S比值<2、淋巴门结构消失、淋巴结囊性变占比大于良性增生性结节(P<0.05)。结论:彩超可通过影像学特征判断结节良恶性,对恶性甲状腺结节及淋巴结转移具有较高诊断价值。

Objective:To evaluate the diagnostic value of color Doppler ultrasonography(color ultrasound)in malignant thyroid nodules and lymph node metastasis.Methods:116 patients with thyroid nodules admitted to our hospital from April 2021 to April 2023 were selected as the study objects.With pathological results as the"gold standard",color ultrasound results were compared with pathological results.The ultrasonic features of benign and malignant nodules were compared.The results of lymph node metastasis were compared between color ultrasound and pathology.The imaging findings of benign hyperplastic lymph nodes and metastatic lymph nodes were compared.Results:Among 116 patients with thyroid nodules,62 cases were malignant and 54 cases were benign.The diagnostic sensitivity,specificity and accuracy of color ultrasound were 96.77%,96.30%and 96.55%.The incidence of irregular lesion,unclear boundary,silent halo,low echo and microcalcification in malignant nodules was higher than that in benign nodules(P<0.05).In 62 patients with malignant thyroid nodules,a total of 102 enlarged lymph nodes were detected by ultrasonography,34 benign hyperplastic lymph nodes and 68 metastatic lymph nodes were pathologically diagnosed.The sensitivity,specificity and accuracy of ultrasound diagnosis were 79.41%,88.24%and 82.35%.The L/S ratio of metastatic lymph nodes was<2,the structure of lymphatic portal disappeared,and the proportion of cystic lymph nodes was greater than that of benign hyperplastic nodules(P<0.05).Conclusion:Color ultrasound can be used to identify benign and malignant nodules by imaging features,and has a high diagnostic value for malignant thyroid nodules and lymph node metastasis.