高频超声检查联合彩色多普勒血流显像检查相关参数在甲状腺结节定性诊断中的应用价值  

The Value of High-frequency Ultrasonography Combined with Color Doppler Flowmetry in the Qualitative Diagnosis of Thyroid Nodules

作　　者：胡张艳 柴贝贝 张晓杰 Hu Zhangyan;Chai Beibei;Zhang Xiaojie(Color Ultrasound Room,Wugang People's Hospital,Pingdingshan,Henan,462599,China)

机构地区：[1]舞钢市人民医院彩超室,河南平顶山462599 [2]舞钢市人民医院外五科,河南平顶山462599

出　　处：《黑龙江医学》2023年第14期1711-1713,共3页Heilongjiang Medical Journal

摘　　要：目的:分析高频超声(HFUS)检查联合彩色多普勒血流显像(CDFI)检查相关参数在甲状腺结节定性诊断中的应用价值。方法:选取2020年1月—2022年4月舞钢市人民医院收治的114例甲状腺结节患者作为研究对象,均行HFUS、CDFI检查。将病理结果作为诊断金标准,统计并比较甲状腺结节患者弹性分级、HFUS声像图特点、CDFI血流形态、丰富程度等指标以及HFUS、CDFI单一及联合检查的诊断结果与效能。结果:病理检查发现,114例甲状腺结节患者中良性77例(增生结节49例、滤泡状腺瘤28例),恶性37例(乳头状腺癌31例、髓样癌6例)。与甲状腺良性结节患者比较,甲状腺恶性结节患者血流形态多为Ⅲ~Ⅴ型,丰富程度多为2~3级,弹性分级较高,差异有统计学意义(χ^(2)=45.074、39.036,P<0.05)。甲状腺恶性结节患者周围无回声率、内部低回声率、边界不整率、微钙化灶率、淋巴结转移率均较甲状腺良性结节患者高,差异有统计学意义(χ^(2)=17.607、27.315、10.584、22.986、24.574,P<0.05)。HFUS+CDFI联合诊断的灵敏度较HFUS、CDFI单一诊断高,漏诊率较HFUS、CDFI单一诊断低,且约登指数最大,差异有统计学意义(χ^(2)=9.652、9.652,P<0.05)。结论:HFUS能有效显示甲状腺结节形态特点,CDFI可帮助临床了解甲状腺结节血流特征,两者联合使用能为临床鉴别、定性甲状腺结节提供依据,提高诊断灵敏度,减少漏诊的发生。Objective:To analyze the value of high-frequency ultrasonography(HFUS)combined with color Doppler flow imaging(CDFI)in the qualitative diagnosis of thyroid nodules.Methods:114 patients with thyroid nodules admitted to the hospital from January 2020 to April 2022 were selected for the study,and all of them underwent HFUS and CDFI.Using pathological findings as the diagnostic gold standard,the diagnostic results and efficacy of patients with thyroid nodules in terms of elasticity grading,HFUS sonographic features,CDFI blood flow pattern and abundance,as well as HFUS and CDFI single and combined examinations were counted and compared.Results:Pathological examination revealed that 77 of the 114 patients with thyroid nodules were benign(49 hyperplastic nodules and 28 follicular adenomas)and 37 were malignant(31 papillary adenocarcinomas and 6 medullary carcinomas).Compared with patients with benign thyroid nodules,patients with malignant thyroid nodules had more type III to V blood flow patterns,richness of grade 2 to 3,and higher elasticity grading,with statistically significant differences(χ^(2)=45.074,39.036,P<0.05).The rates of peripheral anechoic,internal hypoechoic,border irregularity,microcalcified foci,and lymph node metastasis were higher in patients with malignant thyroid nodules than in patients with benign thyroid nodules,with statistically significant differences(χ^(2)=17.607,27.315,10.584,22.986,24.574,P<0.05).The combined diagnosis of HFUS+CDFI had higher sensitivity and lower leakage rate than the single diagnosis of HFUS and CDFI,and the Jorden index was the largest,and the difference was statistically significant(χ^(2)=9.652,9.652,P<0.05).Conclusion:HFUS can effectively display the morphological characteristics of thyroid nodules,and CDFI can help clinical understanding of the blood flow characteristics of thyroid nodules.The combination of the two can provide a basis for clinical identification and characterization of thyroid nodules,improve diagnostic sensitivity,and reduce the occurrence of mis

关 键 词：高频超声 彩色多普勒血流显像 甲状腺结节 血流形态 声像图 弹性分级 

分 类 号：R445.1[医药卫生—影像医学与核医学]