彩色多普勒超声诊断甲状腺癌的临床价值  

Clinical value of color Doppler ultrasound in diagnosis of thyroid carcinoma

作　　者：林洁[1] 

机构地区：[1]绵阳市中心医院超声科,四川绵阳621000

出　　处：《中国医学物理学杂志》2015年第3期440-443,共4页Chinese Journal of Medical Physics

摘　　要：【摘要】目的：探讨彩色多普勒超声对甲状腺癌（Thyroid Carcinoma，TC）的临床诊断价值。方法：回顾性分析我院2012年1月--2014年10月收治的98例经病理确诊的TC患者的临床资料，均行彩色多普勒超声检查。观察肿瘤位置、数量、边界、内部回声及形态，观察肿块血流分布，测量血流阻力指数，探查颈部是否伴淋巴结肿大。结果：TC患者典型声像图特征为：边界模糊不清的实质性低回声，且内部伴砂粒样钙化；结节的血流分型：Ⅰ型10个、Ⅱ型28个、Ⅲ型54个、Ⅳ型30个；106个结节阻力指数大于0．7，25例患者出现淋巴结转移；彩色多普勒超声对单发性结节的诊断准确率91．86％，显著高于多发性结节的44．44％（P〈0．01）；与肿块直径大于20mm者相比，肿块直径不足20nun者等回声或高回声结节数量更少（P〈0．01）；与年龄不足40岁者相比，年龄超过40岁者等回声或高回声结节数量更少（P〈0．01）；径线≤10mm的结节横纵比≥1的概率更高（P〈0．01）。结论：TC患者的彩色多普勒超声声像图具有一定特征性，彩超对TC的诊断与鉴别具有重要临床应用价值。Objective To investigate the clinical value of color Doppler ultrasound in the diagnosis of thyroid carcinoma （TC）. Methods The clinical data of 98 patients, admitted to our hospital from January 2012 to October 2014 and pathologically diagnosed as TC, were retrospectively analyzed and examined by color Doppler ultrasound. The tumor location, number, boundary, internal echo, shape, and blood flow distributions were observed, and the blood flow resistance index （RI） was measured. The cervical lymph node was examined to confirm whether or not the neck was accompanied with the enlargement of lymph node. Results The TC patients had typical ultrasonographic features, such as substantial lowly echoic with blurred boundary, and the interior with grit calcification. The blood types of the nodule were 10 for type Ⅰ, 28 for type Ⅱ, 54 for type Ⅲ and 30 for type Ⅳ. The RI of 106 nodules were greater than 0.7 and 25 patients developed lymph node metastasis. The accuracy rate of color Doppler ultrasound in the diagnosis of solitary nodule was 91.86%, significantly higher than 44.44%, the accuracy rate of color Doppler ultrasound in the diagnosis of multiple nodules （P〈0.01）. Compared with tumor with 20 mm or greater in diameter, the number of the isoechoic and hyperechoic nodule of the tumor with a diameter of less than 20 mm was smaller （P〈0.01）. Compared with patients under 40 years of age, the number of the isoechoic and hyperechoic nodule of those over 40 years of age was smaller （P〈0.01）. And when the diameter of transverse and longitudinal line was less than or equal to 10 mm, the ratio had higher probability of equaling to or more than 1 （P〈0.01）. Conclusion The color Doppler ultrasonography of patients with TC has particular characteristics, which has important value on the diagnosis and identification of TC.

关 键 词：彩色多普勒超声 甲状腺癌 

分 类 号：R736.1[医药卫生—肿瘤]