甲状腺癌诊断和鉴别诊断中超声的应用价值研究

The value of ultrasonography in the diagnosis and differential diagnosis of thyroid

目的:分析甲状腺癌诊断和不同病理类型甲状腺癌鉴别诊断中高频超声的应用价值。方法:本研究纳入对象均为2014年1月~2016年6月期间收治并经手术病理证实的甲状腺癌患者作为观察对象,共82例。选择同期经手术病理证实为甲状腺腺瘤的患者82例作为对照对象。应用高频超声对两组患者进行诊断。对甲状腺癌组、甲状腺腺瘤组患者在高频彩超诊断下的病灶结节血流参数以及血流分级情况进行观察,并对比不同病理类型甲状腺癌患者在高频彩超上的特征。结果:高频彩超诊断下,甲状腺癌组患者最大峰值流速检出值为(49.75±12.26)cm/s,阻力指数检出值为(0.73±0.12),均显著高于甲状腺腺瘤组,对比差异显著(P<0.05),具有统计学意义。高频彩超诊断下,甲状腺癌组患者病灶结节血流分级Ⅰ级构成比为12.20%(10/82),Ⅱ级构成比为39.02%(32/82),Ⅲ级构成比为48.78%(40/82),整体血流分级显著高于甲状腺瘤组,对比差异显著(P<0.05),具有统计学意义。甲状腺癌患者均有边界模糊不清、周边无完整低回声晕或稍低回声、分布不均匀、局部可见细小钙化等超声图像特征,但同时也具有各自的特征。结论:高频彩超能够对甲状腺病灶结节良恶性情况进行准确评价,在甲状腺癌临床诊断中有良好的应用价值。同时,甲状腺乳头状癌、髓样癌、以及滤泡状癌在高频彩超表现上有一定重叠,但同时也具有各自的特征,在临床诊断时应结合患者临床特点以及彩超特征进行综合考虑,以明确诊断。

Objective:To analyze the value of high-frequency ultrasonography in the differential diagnosis of thyroid carcinoma and different pathological types of thyroid carcinoma.Methods:Twenty-eight patients with thyroid cancer who were admitted to our hospital from January 2014 to June 2016 were enrolled in our study.All patients were confirmed by surgery and pathology.82 patients with thyroid adenoma confirmed by operation and pathology were selected as the control group.Two groups of patients were diagnosed by high frequency ultrasonography.Thyroid cancer group,thyroid tumor group in patients under high-frequency color Doppler diagnosis of nodular blood flow parameters and blood flow classification were observed and compared with different pathological grades of thyroid cancer patients in the characteristics of high frequency color Doppler ultrasound features.Result:The maximum peak flow velocity was(49.75±12.26)cm/s and the resistance index was(0.73±0.12)in thyroid carcinoma group,which was significantly higher than that in thyroid adenoma group,(P <0.05),which was statistically significant.Under the high frequency color Doppler ultrasonography,thyroid cancer patients’ nodule blood flow gradeⅠstage ratio was 12.20%(10/82),gradeⅡ was 39.02%(32/82),gradeⅢ was 48.78% 40/82).The overall blood flow grade was significantly higher than that of thyroid tumor group(P <0.05),which was statistically significant.Thyroid cancer patients have blurred boundaries,peripheral hypoechoic halo or slightly hypoechoic echo,uneven distribution,localized small calcification and other ultrasound image features,but also has its own characteristics.Conclusion:High-frequency color Doppler ultrasound can accurately evaluate the benign and malignant nodules of thyroid nodules,and it has a good application value in the clinical diagnosis of thyroid carcinoma.At the same time,thyroid papillary carcinoma,medullary carcinoma,and follicular carcinoma in the high-frequency color Doppler ultrasound performance on a certain overlap,but also has its own characteristics in clinical diagnosis should be combined with clinical features and color Doppler ultrasound features comprehensive consideration,To confirm the diagnosis.