高频彩色多普勒超声在甲状腺癌诊断中的应用价值

[目的]探讨高频超声检查在诊断甲状腺癌中的应用价值,总结甲状腺癌超声图像特征.[方法]观察56例甲状腺癌患者的二维超声表现、彩色多普勒血流特征以及颈部淋巴结的转移情况,并与手术及病理结果对照分析.[结果]超声检查56例甲状腺癌患者,发现69个病灶,检出率为100％,以病理诊断为标准,超声和病理诊断的符合率为87.5％,术前超声未明确诊断为12.5％.甲状腺癌二维超声图像表现的特征是类圆形或椭圆形,边缘不规则,无包膜,常呈毛刺状或分叶状,甲状腺微小癌实质为不均匀低回声,纵横比大于1,较大结节可为低回声或中等回声,癌结节内常可见簇状分布的细小点状砂粒样钙化体,彩色多普勒显示结节周边及内部可见条状、短棒状及分支状血流信号,54例患者肿瘤内脉冲多普勒可探测出高阻力搏动性动脉频谱.36例患者伴有颈部淋巴结转移,占64.3％.[结论]高频彩色多普勒超声显像对甲状腺癌检出率高,能充分显示肿瘤的二维图像特征、血流分布状态及颈部淋巴结转移情况,应作为甲状腺癌筛查及术前检查的首选方法.

The value of high frequency color Doppler ultrasonography in diagnosis of thyroid carcinoma

[Objective] To investigate the value of uhrasonography in diagnosis of thyroid carcinoma, and summary the ultrasonography features of thyroid carcinoma. [ Methods ] The two-dimensional ultrasound performances , colorful Doppler blood flow and the cervical lymph node metastasis features were observed in 56 cases with thyroid carcinoma, and compared with operations and postoperative pathologic results. [ Results] After examining of 56 cases of thyroid carcinoma patients, the result found in 69 lesions, the detection rate was 100%, take the pathological diagnosis as standard, the ultrasonic and pathological diagnosis were 87.5%. The two-dimensional ultrasound specific performances of 56 cases with thyroid carcinoma included round-like or oval shape, irregular border, no peplos, border with burr or lobulated shape. Tiny cancers in thyroid showed heterogeneous hypoechoic, aspect ratios〉 1, larger nodules showed hypoechoic or isoechoic. The nodules accompanied with clumps of small point-like sand-like calcifications. Short clubbed or branching of blood flow could be found in the surrounding or internal parts of tumors on colorful Doppler. High-resistance pulsatile artery spectrum could be detected in the nodules on pulse Doppler of 54 patients. 36 patients with cervical lymph node metastasis,accounted for 64.3%. [Conclusions] Hyper-frequency colorful Doppler ultrasonography has high detection rate in thyroid carcinoma, can fully represent the two-dimensional ultrasound feature, blood flow distribution and cervical lymph node metastasis of tumor, it should be the preoperative preferred examination of thyroid carcinoma.