甲状腺结节应用高频超声声像图特点及彩色多普勒血流特征分析  

Characteristics of high frequency ultrasonography and color Doppler flow imaging in thyroid nodules

作　　者：郑岩岩 王洪序 刘绍玲[3] 张国全[1] 

机构地区：[1]山东大学附属省立医院超声科,山东济南250021 [2]山东省济南市第七人民医院,山东济南250000 [3]山东省医学影像学研究所超声诊断研究室,山东济南250021

出　　处：《医学影像学杂志》2017年第10期1870-1874,共5页Journal of Medical Imaging

摘　　要：目的探讨甲状腺结节应用高频超声与彩色多普勒超声的声像图特点及血流特征,以便为临床诊治提供依据。方法将我院2014年4月~2017年4月收治的甲状腺结节患者90例作为研究对象,根据良恶性病变分为甲状腺良性结节组、甲状腺恶性结节组,前者50例、后者40例,均接受高频超声与彩色多普勒超声诊断及检查,观察与记录两组患者声像图特点与血流特征及单一诊断与联合诊断符合率,同时进行组间统计学分析。结果甲状腺良性结节组与甲状腺恶性结节组在高频超声声像图特征如周围无回声、内部低回声、边界不整、淋巴结转移、微钙化灶等方面存在明显差异(P<0.05);甲状腺良性结节组与甲状腺恶性结节组在血流分布等级、血流参数(PSV、RI)上均有明显差异(P<0.05);高频超声诊断符合率为88.89%、彩色多普勒超声诊断符合率为90.00%,比较无差异(P>0.05),联合诊断符合率为98.89%,明显高于单一诊断(P<0.05)。结论甲状腺结节在良性与恶性上存在不同的高频超声声像图特点及彩色多普勒血流特征,根据各自的特点与特征,能为临床鉴别诊断良性与恶性甲状腺结节提供依据,若能有效结合二者特点进行诊断与评估,可提高诊断符合率,值得重视。Objective To investigate the characteristics of high frequency ultrasound and color Doppler ultrasound for thyroid nodules and their clinical usefulness for diagnosis and treatment. Methods The study involves 90 patients collected in our hospital from April 2014 to April 2017,compromised of 50 cases of benign nodules and 40 cases of malignant nodules respectively. All the patients underwent high frequency ultrasound and color Doppler ultrasound examination before surgical operation. The characteristics of high frequency ultrasound and several parameters of color Doppler ultrasound were recorded and compared with pathology results and used for diagnostic value calculation and statistical analysis. Results There are statistically differences（ P〈0. 05） between the benign and malignant groups in the high frequency ultrasound features such as halo,low internal echo,boundary irregularity,lymph node metastasis and micro calcification. Also there are statistically differences（ P〈0. 05） between the two groups in the color Doppler parameters such as semi-quantity blood flow distribution,peak systolic velocity（ PSV） and resistance index（ RI）. The diagnosis coincidence rate were 88. 89% with high frequency ultrasound and 90. 00% with color Doppler ultrasound respectively,and the diagnosis coincidence rate would be 98. 89% with combined techniques of high frequency and color Doppler ultrasound,obviously higher than any single technique（ P〈0. 05）. Conclusion There are differences between the benign and malignant thyroid nodules with high frequency ultrasound characteristics and color Doppler ultrasound features. According to the differences,we can provide reliable diagnostic basis for differential diagnosis between thyroid benign and malignant nodules. The diagnostic rate can be further promoted if combined techniques are applied and this is worth of clinical attention.

关 键 词：甲状腺结节 良性 恶性 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]