CDFI与超声造影联合检测对甲状腺结节良恶性鉴别诊断的价值  

Usage of Combined Color Doppler Ultrasound Flow Imaging and Contrast-Enhanced Ultrasonography in the Differential Diagnostic of Benign and Malignant Thyroid Nodules

作　　者：黄剑毅[1] 王瑶[1] 曾曦[1] 赵海燕[1] 

机构地区：[1]广东省惠州市第三人民医院超声科,广东惠州516002

出　　处：《医学临床研究》2016年第6期1096-1099,共4页Journal of Clinical Research

摘　　要：【目的】分析彩色多普勒血流显像（CDFI）与超声造影（CEUS）对良恶性甲状腺结节的超声诊断特征，为其鉴别诊断提供参考。【方法】回顾性分析本院2013年6月至2015年9月手术治疗的132例甲状腺结节患者超声诊断资料，以术后病理结果为金标准，观察良恶性结节内CDFI显示的血流形态、血流丰富程度，CEUs增强模式和增强强度特征；比较两种方法单独诊断及联合诊断的准确性。【结果】CDFI显示良恶性甲状腺结节血流形态及血流丰富程度比较差异具有显著性，良性结节血流形态以Ⅰ／Ⅱ型为主，血流丰富程度以0～1级居多，而恶性结节血流形态多为ⅢjⅣjV型，血流丰富程度多为2～3级（P〈0．05）；CEUS显示良恶性甲状腺结节增强模式和增强强度比较差异具有显著性，良性结节增强模式多为环状周边增强，增强强度多为稀疏增强，而恶性结节增强模式以弥漫性整体增加居多，增强强度多为高增强（P〈0．05）；TIC曲线定量分析，良性甲状腺结节AT、TTP、△I参数高于恶性甲状腺结节，但IPI、PPI、8参数低于恶性甲状腺结节（P〈0．05）。CDFI与CEUS联合诊断准确性、敏感性、特异性、阳性和阴性预测值均高于单独诊断。【结论】良恶性甲状腺结节CDFI特征较明显，但微小病灶的鉴别诊断有一定难度，CEUS可提高血流检出率，二者联合具有较高的临床价值。[Objective]To analyze the diagnostic characteristics of benign and malignant thyroid nodules by Color Doppler Ultrasound Flow Imaging （CDFI） with Contrast-Enhaneed Ultrasound（CEUS）to provide reference for improving differential identification. [Methods]A retrospective analysis of 132 thyroid mass surgical cases from June 6, 2013 to September 2015 was conducted for the study. Data of all patients with thyroid nodule ultrasound diagnosis was compared with postoperative pathological results, which were considered the gold diagnostic criterion. The observation of the color Doppler ultrasound blood flow form and richness from CDFI, ultrasound enhancement patterns, and enhanced strength characteristics from CEUS were different in benign and malignant thyroid nodules. Furthermore, the accuracy of CDFI and CEUS alone and combination in thyroid nodule diagnosis were evaluated. [Results]CDFI showed that the blood flow form and richness degree in benign and malignant thyroid nodules were significant different. Blood flow form is given priority to type Ⅰ/Ⅱ, and blood flow abundance in the majority of benign nodules ranked level 0-1. However, blood flow in the malignant nodules mostly formed type Ⅲ/Ⅳ/Ⅴ and blood abundance leveled 2 - 3 （ P 〈 0.05）. On the other hand, CEUS revealed that ultrasound enhancement pattern and enhanced strength were significantly different between benign and malignant thyroid nodules. The enhancement pattern in benign nodules was circular peripheral enhancement and enhancement strength was sparse. In contrast, the enhancement pattern in the majority of malignant nodules was increased with overall diffuse, and the same was seen as to their enhancement strength （ P 〈0.05）. TIC curve of quantitative analysis demonstrated that the AT, TTP, delta I parameters in benign thyroid nodules were higher than those in malignant thy roid nodules. However, IPI, PPI, beta parameters were lower in malignant thyroid nodules than in benign ones （ P 〈0.05）. Taken together, CDFI with

关 键 词：超声心动描记术 多普勒 甲状腺结节/超声检查 甲状腺结节/放射摄影术 

分 类 号：R736.1[医药卫生—肿瘤]