彩色多普勒超声联合二维超声鉴别诊断甲状腺结节良恶性的价值研究  

Value of color Doppler ultrasound combined with two-dimensional ultrasound in the differential diagnosis of benign and malignant thyroid nodules

作　　者：王海宁 Wang Haining(Department of Ultrasound medicine,Fanxian People′s Hospital,Puyang 457500,China)

机构地区：[1]河南省濮阳市范县人民医院超声医学科,457500

出　　处：《实用医学影像杂志》2024年第4期292-295,共4页Journal of Practical Medical Imaging

摘　　要：目的 探究甲状腺良恶性结节应用彩色多普勒超声联合二维超声的诊断价值。方法 纳入我院2020年8月至2022年9月收治的甲状腺结节患者88例,均行彩色多普勒超声及二维超声检查。以病理结果为“金标准”,对比不同性质甲状腺结节超声特征和血流动力学参数,分析不同检查方法对甲状腺结节的诊断价值并计算一致性。结果 甲状腺恶性结节钙化情况、边界模糊、直径≥2 mm、丰富的血流情况发生率均高于良性结节(P<0.05)。甲状腺恶性结节收缩期峰值血流流速(PSV)水平及阻力指数(RI)均高于良性结节,舒张末期血流速度(EDV)水平低于良性结节(P<0.05)。联合检测在甲状腺结节良恶性中的诊断价值均高于单项检测(P<0.05)。一致性检验显示,二维超声、彩色多普勒超声均与病理学检查的一致性尚可(kappa值=0.434、0.696,P<0.001);二者联合检查与病理学检查一致性良好(kappa值=0.891,P<0.001)。结论 2种超声检查联合在鉴别诊断良恶性甲状腺结节中具有较高的临床应用价值,诊断一致性较强,能够清晰明确病灶内血流情况,为临床鉴别诊断提供有效参考,值得推广应用。Objective To explore the diagnostic value of color Doppler ultrasound combined with two-dimen-sional ultrasound in the diagnosis of benign and malignant thyroid nodules.Methods A total of 88 patients with thy-roid nodules admitted to our hospital from August 2020 to September 2022 were included,and all of them underwent color Doppler ultrasound and two-dimensional ultrasound examination.Taking the pathological results as the"gold standard",the ultrasound characteristics and hemodynamic parameters of different types of thyroid nodules were com-pared,and the diagnostic value of diferent examination methods for thyroid nodules was analyzed and the consistency was calculated.Results The incidence of calcification,blurred boundary,diameter≥2 mm,and rich blood flow in malignant thyroid nodules was higher than that in benign nodules(P<0.05).The peak systolic velocity(PSV)and resis-tance index(RI)of malignant thyroid nodules were higher than those of benign nodules,and the end diastolic velocity(EDV)was lower than that of benign nodules(P<0.05).The diagnostic value of combined detection in the diagnosis of benign and malignant thyroid nodules was higher than that of single detection(P<0.05).Consistency test showed that 2D ultrasound and color Doppler ultrasound were consistent with pathological examination(kappa value=0.434,0.696,P<0.001).The combined examination was in good agreement with the pathological examination(kappa=0.891,P<0.001).Conclusion The application of color Doppler ultrasonography combined with two-dimensional ultrasonography in the diagnosis of benign and malignant thyroid nodules has high application value and strong consistency,which can clearly define the blood flow in the lesion,provide effective reference for clinical differential diagnosis,and is worthy of promotion and application.

关 键 词：甲状腺结节 超声检查 多普勒 彩色 二维超声检查 一致性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]