甲状腺结节良恶性的彩色多普勒超声特征及其诊断价值分析  

Color Doppler Ultrasound Characteristics and Diagnostic Value of Benign and Malignant Thyroid Nodules

作　　者：方娣 姚晓漫 孙文静 陆蒙 王超[1] FANG Di;YAO Xiao-man;SUN Wen-jing;LU Meng;WANG Chao(Color Doppler Room,The First People's Hospital of Hefei,Hefei,Anhui,230061,China)

机构地区：[1]合肥市第一人民医院彩超室,安徽合肥230061

出　　处：《现代生物医学进展》2020年第1期158-161,共4页Progress in Modern Biomedicine

基　　金：安徽省科技攻关项目(1603A0820098)。

摘　　要：目的:研究甲状腺结节良恶性的彩色多普勒超声特征及其诊断价值。方法:选取从2016年3月~2019年2月于我院接受手术治疗的甲状腺疾病患者300例作为研究对象,均予以彩超检查,比较甲状腺良恶性结节的超声特征(主要包括直径、钙化情况、边界、回声、血流状况)。以病理活检结果为金标准,分析彩超诊断甲状腺结节良恶性的敏感性、特异性以及准确度。对比甲状腺良恶性结节的血流分型情况以及各项血流动力学参数。结果:恶性结节超声特征直径≥2 cm、有钙化、边界模糊、无回声/低回声、血流丰富人数占比均高于良性结节(均P<0.05)。以手术病理组织活检结果作为金标准,彩色多普勒超声诊断甲状腺结节的敏感性、特异性以及准确度分别为97.73%、86.11%、96.33%。甲状腺良性结节血流分型为Ⅰ型、Ⅱ型人数占比高于恶性结节,而Ⅲ型、Ⅳ型人数占比低于恶性结节(均P<0.05)。甲状腺良性结节的收缩期峰值血流速度(PSV)、阻力指数(RI)均低于恶性结节,而舒张末期血流速度(EDV)高于恶性结节(均P<0.05)。结论:彩色多普勒超声对甲状腺结节良恶性的鉴别价值较高,且具有较高的敏感性、特异性以及准确度,可为甲状腺良恶性结节的早期诊断、临床治疗提供重要的参考依据。Objective:To study the color Doppler ultrasonographic characteristics of benign and malignant thyroid nodules and its diagnostic value.Methods:300 patients with thyroid diseases who underwent surgery in our hospital from March 2016 to February 2019 were selected as the study subjects.All patients were examined by color Doppler ultrasonography to compare the sonographic features of benign and malignant thyroid nodules(including diameter,calcification,boundary,echo and blood flow).The sensitivity,specificity and accuracy of color Doppler ultrasonography in the diagnosis of benign and malignant thyroid nodules were analyzed based on the results of pathological biopsy.The blood flow patterns and hemodynamic parameters of benign and malignant thyroid nodules were compared.Results:The proportion of malignant nodules with diameter≥2 cm,calcification,blurred boundary,anechoic/hypoechoic and rich blood flow was higher than that of benign nodules(all P<0.05).The sensitivity,specificity and accuracy of color Doppler ultrasonography in the diagnosis of thyroid nodules were 97.73%,86.11%and 96.33%,respectively.The proportion of benign thyroid nodules with blood flow typesⅠandⅡwas higher than that of malignant nodules,while the proportion of typeⅢandⅣwas lower than that of malignant nodules(all P<0.05).The peak systolic blood flow velocity(PSV)and resistance index(RI)of benign thyroid nodules were lower than those of malignant thyroid nodules,while the end diastolic blood flow velocity(EDV)of benign thyroid nodules was higher than that of malignant thyroid nodules(all P<0.05).Conclusion:Color Doppler ultrasonography is of high value in differentiating benign and malignant thyroid nodules,and has high sensitivity,specificity and accuracy.It can provide important reference for early diagnosis and clinical treatment of benign and malignant thyroid nodules.

关 键 词：甲状腺结节 彩色多普勒超声 诊断 血流动力学 

分 类 号：R736.1[医药卫生—肿瘤] R653[医药卫生—临床医学]