彩色多普勒血流显像及三维彩色血管能量成像在甲状腺结节性病变的临床应用  

Clinical application research： color doppler flow image and three dimensional color power angiography in the diagnosis of thyroid nodules

作　　者：王虹[1] 王影[1] 王洪波[1] 王晓蕾[1] 侯秀娟[1] 周显礼[1] 田家玮[1] 

机构地区：[1]哈尔滨医科大学附属第二医院超声科,150086

出　　处：《中国地方病学杂志》2010年第4期452-454,共3页Chinese Jouranl of Endemiology

摘　　要：目的 探讨彩色多普勒血流显像（CDFI）及三维彩色血管能量成像（3D-CPA）对甲状腺结节性病变的临床诊断价值.方法 2008年1月-2009年5月,在哈尔滨医科大学附属第二医院超声医学科,选择甲状腺结节患者30例共62个结节,在手术前进行CDFI及3D-CPA检查,根据手术病理结果将结节划分为结节性甲状腺肿、甲状腺腺瘤和甲状腺癌组,分析3组甲状腺结节的血流形态、分布和血流动力学特征的差异.结果 3D-CPA检查结果表明,结节性甲状腺肿血管以外周分布为主,甲状腺腺瘤呈球形网状结构,甲状腺癌血管内径明显增粗,不均匀扭曲.结节性甲状腺肿、甲状腺腺瘤、甲状腺癌组的收缩期峰值流速（PSV）分别为（39.43±11.17）、（46.39±12.98）、（65.17±9.23）cm/s,阻力指数（RI）分别为（0.32±0.08）、（0.41±0.06）、（0.69±0.07）,甲状腺癌组的PSV和RI均高于结节性甲状腺肿和甲状腺腺瘤组（P均〈0.05）,CDFI和3D-CPA检查,甲状腺癌组的血流分级均高于结节性甲状腺肿组和甲状腺腺瘤组（χ2值分别为17.11、12.79,23.05、15.41,P均〈0.01）.结论 CDFI显像与3D-CPA能直观地反映甲状腺结节性病变的血流分布状况,有助于甲状腺结节性疾病的诊断与鉴别诊断.Objective To evaluate the clinical value of color doppler flow image （CDFI） and three-dimension color power angiography（3D-CPA） in the diagnosis of thyroid nodules. Methods A total of 62 pathologically confirmed thyroid nodules of 30 patients were analyzed. All the patients underwent ultrasound examination and operation in the Second Affiliated Hospital of Harbin Medical University between January, 2008 and May, 2009. Both CDFI and 3D-CPA were performed before the operation. All the nodules were divided into three groups including nodular goiters, thyroid adenomas and thyroid cancers according to the pathological results. The hemodynamic features and the vascular morphology characteristics of nodules in different groups were compared. Results 3D-CPA showed that blood vessels of nodular goiters commonly distributed surrounding the mass and the inner vessels were thin and regular, thyroid adenomas were bulb-shaped and netted structure, and malignant thyroid nodules displayed distorted and irregular distributed vessels. Peak systolic velocity （PSV）of the three groups were （39.43±11.17a）, （46.39±12.98） and （65.17±9.23）cm/s, respectively. Resistance index（RI） of the three groups were （0.32±0.08）, （0.41±0.06） and （0.69±0.07）cm/s, respectively. Both PSV and RI in malignant thyroid nodules were higher than in nodular goiters and in thyroid adenomas and the difference were statistical significant （all P 〈 0.05）. The blood flow grade of malignant nodules was also higher in malignant nodules than in other two groups（χ2 = 17.11, 12.79, 23.05, 15.41, P〈 0.01）. Conclusions CDFI and 3D-CPA could visually demonstrate the characteristic and distribution of the inner and outer blood vessels, display the vessels structures, and they are benefit the differential diagnosis of thyroid nodules.

关 键 词：甲状腺结节 彩色多普勒血流成像 三维彩色血管能量成像 

分 类 号：R686[医药卫生—骨科学]