彩色多普勒超声对甲状腺癌的诊断价值(1)
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[摘要] 目的 探讨彩色多普勒超声在甲状腺癌诊断及鉴别诊断中的应用价值。 方法 回顾分析我院甲状腺结节患者127例，恶性结节80个，甲状腺良性结节112个，全部经手术病理证实。 结果 80个恶性结节与112个良性结节的声像图特征分析对比，甲状腺癌主要表现为形态不规则、多为单发、内部回声杂乱，多为低回声，分枝型血流，血流信号走行杂乱；脉冲多普勒显示动脉血流呈高阻力性血流。结果显示，结节形态、边界、内部回声、微钙化及血流分级、阻力指数等方面比较，两组差异有统计学意义(P < 0.05)。良、恶性结节动脉峰值流速比较差异无统计学意义(P > 0.05)。 结论 彩色多普勒超声对甲状腺结节术前诊断及鉴别诊断具有重要意义。
[关键词] 彩色多普勒超声；诊断；甲状腺癌
[中图分类号] R445.1；R736.1 [文献标识码] B [文章编号] 1673-7210(2012)02(a)-0093-03
Clinical value of color Doppler ultrasound in the diagnosis of thyroid carcinoma
ZHANG Ailian
The Third People's Hospital, Shandong Province, Heze 274031, China
[Abstract] Objective To investigate the clinical value of color Doppler ultrasound in differential diagnosis of thyroid carcinoma. Methods 69 patients with thyroid cancer (80 m alignant nodules) were retrospectively analyzed, 112 benign nodules, all patients were confirmed through pathology. Results The ultrasonographic features of 80 m alignant nodules were analyzed and compared with 112 benign nodules, and thyroid cancer can be described as irregular, mostly single, internal echo clutter, mostly hypoecho, branch-type and messy blood flow; pulse Doppler showed artery blood flow as a high resistance to blood flow. The results showed that nodule shape, border, internal echo, micro calcifications and flow grade and resistance index of two groups were significant differences (P < 0.05). The difference of benign and m alignant nodules peak arterial velocity was not statistically significant (P > 0.05). Conclusion Color Doppler ultrasound is important in the preoperative diagnosis and differential diagnosis of thyroid nodules.
[Key words] Color Doppler ultrasound; Diagnosis; Thyroid cancer
本文探讨甲状腺癌彩色血流显像及相关二维图像的特征，评价彩色多普勒超声在其鉴别诊断中的临床价值。超声检查可以发现甲状腺的小病灶，彩色多普勒血流显像还可以反映甲状腺结节的血流动力学特征对甲状腺癌的早期发现及诊治提供一定的帮助[1]。
1 资料与方法
1.1 一般资料
选择2007年1月~2010年12月在我院就诊的甲状腺结节患者127例，结节共192个。其中，女97例，男30例；年龄19～81岁，平均43.3岁。所有患者均行手术切除，病理证实甲状腺乳头状癌61例，滤泡状癌3例，未分化癌2例，乳头状癌合并未分化癌2例，髓样癌1例，甲状腺腺瘤21例，结节性甲状腺肿37例。多发结节共43例，甲状腺癌合并良
性结节16例。
1.2 仪器与方法
采用Neusoft FLYING彩色多普勒超声诊断仪，由超声科专业医师操作，线阵探头频率7.5～10.0 MHz。患者取仰卧位， 并垫高肩部，头后仰，充分显露颈部。二维图像观察病灶的大小、形态、边界、数目、回声及有无钙化等，彩色多普勒观察内部及周边的血流分布与丰富程度 ......
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