高频彩色多普勒超声在甲状腺癌诊断中的应用价值

目的探讨高频彩色多普勒超声在甲状腺癌诊断中的应用价值及其特征表现。方法对经手术及病理证实的65例甲状腺癌患者（腺癌组）二维及彩色多普勒（CDFI）声像图资料进行回顾性分析,并与30例甲状腺瘤（良性组）进行对比分析。结果腺癌组声像图主要表现为周边无回声、内部低回声及微钙化,血供以Ⅱ～Ⅲ级为主,PSV和RI分别（42.14±22.35）cm/s、（0.68±0.18）,各指标与良性组比较P均〈0.05。结论高频彩色多普勒超声在甲状腺癌诊断中具有重要价值,低回声、微小钙化及PSV和RI升高、颈部淋巴结肿大为其特征性表现。     

彩色多普勒对血管性认知障碍的诊断价值

目的探讨颈部彩色多普勒对血管性认知障碍（VCI）的早期诊断价值。方法使用彩色多普勒检测55例VCI患者和46例正常老年人（对照组）颈内动脉和椎动脉,分别检测动脉内径、动脉内层中膜厚度（IMT）、收缩期峰流速度（Vmax）、舒张末期流速（Vmin）、平均流速（Vmean）和阻力指数（RI）,并进行比较。结果 VCI组患者血管和血流动力学参数较对照组有明显改变,血流峰速增快、阻力增大、内层中膜厚度增加（P〈0.05或P〈0.01）。结论彩色多普勒是一种早期诊断VCI的有效手段。     

甲状腺癌的高频彩超显像分析

目的探讨高频超声及彩色多普勒对甲状腺癌的诊断价值。方法通过对45例经手术病理证实为甲状腺癌的高频声像图及彩色多普勒血流显像进行回故性分析。结果 45例甲状腺癌肿,超声诊断甲状腺癌（包括提示甲状腺癌可能性大,不排除甲状腺癌等）37例,符合率82.12%。8例诊断不符合,其中7例诊断为结节性甲状腺肿或腺癌,1例诊断为甲状腺结核可能性大。结论高频彩超对甲状腺癌诊断具有重要的价值。     

彩色多普勒超声对乳腺癌癌周脉管癌栓的诊断价值

目的探讨彩色多普勒超声血流检测技术对乳腺癌癌周脉管癌栓的诊断价值。方法回顾性分析101例乳腺癌,病理提示有癌周脉管癌栓者43例(有癌栓组),无癌栓者58例(无癌栓组),对照分析两组的二维超声图像及彩色多普勒血流显像。结果有癌栓组和无癌栓组比较,患者的年龄、肿块大小、组织学分级、有无腋窝淋巴结转移、彩色多普勒超声血流分级差异有统计学意义(P<0.05)。年轻、肿块大、组织学分级高、有腋窝淋巴结转移、超声血流分级高者,容易出现癌周脉管癌栓。结论乳腺癌癌周脉管癌栓与原发瘤肿块大小、病理组织学分级、超声血流分级、有无腋窝淋巴结转移及患者年龄密切相关,彩色多普勒超声对乳腺癌癌周脉管癌栓的术前评估有一定诊断价值。     

彩色多普勒超声对小乳腺癌的诊断价值分析

目的探讨彩色多普勒超声在小乳腺癌中的诊断价值。方法对经病理证实的62例肿块≤2 cm的小乳腺癌患者和39例乳腺良性肿瘤患者的B超及彩色多普勒超声结果进行回顾性分析。二维超声观察肿瘤的形态、边界、内部回声、内部钙化灶及肿瘤纵横径比,彩超观察肿瘤内血流信号、血管支分布情况,测量动脉血流最高流速(Vmax)、搏动指数(PI)和阻力指数(RI)。结果小乳腺癌与良性肿瘤的肿块二维超声声像图表现存在差异,恶性肿块大部分形态不规则,边界不整齐,内部回声不均匀,肿块纵横径比≥1.0,肿块内部出现微小钙化灶。彩超对乳腺良恶性肿块的血流显示率分别为30.7%和95.2%;小乳腺癌肿块内动脉血管走形多表现为传入性和中心性,良性肿块多表现为周围性;恶性肿块动脉血流最高流速(Vmax)、搏动指数(PI)和阻力指数(RI)显著高于良性肿块,差异有统计学意义(P0.01)。结论二维超声结合彩色多普勒显像在提高小乳腺癌的检测率中有重要临床意义。     

阴道彩色多普勒超声参数与老年卵巢癌微血管密度及恶性程度的相关性

目的探讨不同恶性程度的癌变组织阴道彩色多普勒超声(简称彩超)的血管参数及癌微血管密度,并分析指标与癌变组织恶性程度的相关性。方法回顾性分析104例卵巢癌患者临床资料,根据手术后病理诊断结果与临床分期进行分组,将32例病理分型为Ⅰ～Ⅱ期卵巢癌患者纳入A组,将42例Ⅲ～Ⅳ期卵巢癌患者纳入B组,将30例卵巢良性肿瘤患者纳入C组。所有患者进行阴道彩超与卵巢癌微血管密度监测,比较不同恶性程度癌变的老年患者阴道检查血管参数[阻力指数(RI)、最高峰流速(Vmax)]与病灶组织微血管密度[癌微血管密度(MVD)],并分析上述指标与老年卵巢癌患者恶性程度之间的相关性。结果 C组RIA组B组,B组Vmax、MVDA组C组,差异均有统计学意义(均P0.05);RI与老年卵巢癌患者恶性程度呈负相关(r=-0.423,P0.01);Vmax、MVD与老年卵巢癌患者恶性程度呈正相关(r=0.423、0.424,均P0.01)。结论阴道彩超血流参数中RI、Vmax指标水平与老年卵巢癌微血管密度及恶性程度密切相关,有助于老年卵巢癌患者的早期诊断,可为后期治疗提供依据。     

高频超声及CDFI检查在乳腺肿块诊断中的应用

对32例乳腺肿块进行高频超声及彩色血流显像（CDFI）超声检查,并与术后病理检查结果做比较,结果高频超声及CDFI诊断32例肿块中,囊性7例,实质性22例,多发性囊性肿块3例,良性肿块23例、恶性肿块9例,与手术病理对照,肿块检出率100％,对肿块的囊性、实质性、混合性的检出率也是100％。良性肿块1例与手术病理不符,总符合率为96．9％（31／32）。高频CDFI超声对乳腺血管彩色血流的检出率（RI）为72％（24／32）。经手术证实,全部肿块均在超声定位象限内。认为高频超声及CDFI检查在乳腺肿块的诊断中具有较好的应用价值。     

彩超对腹主动脉夹层肾动脉及肾段间动脉血供的检测

目的:探讨彩色多普勒超声在腹主动脉夹层及肾动脉真、假腔供血的检测价值。方法:对75例腹主动脉夹层及150支肾动脉血流的二维及彩色多普勒超声特点进行分析,确定腹主动脉夹层真假腔,将真腔供血及假腔供血的肾动脉及肾段间动脉各分为二组,对血流动力学进行比较。结果:肾动脉真腔供血与假腔供血两组间收缩期峰值流速(Vmax)、平均流速(Vmean)及舒张末期流速(Vmin)均差异有统计学意义(P0.05);阻力指数(RI)与收缩期加速时间(AT)差异无统计学意义(P0.05);真腔供血段间动脉与假腔供血段间动脉的Vmax、Vmean及AT,均差异有统计学意义(P0.05);Vmin及RI间差异无统计学意义(P0.05)。结论:彩色多普勒超声是腹主动脉夹层肾动脉血供初步诊断及监测的最佳无创检查方法。     

多普勒超声对肾动脉狭窄的筛查诊断价值

目的：评价彩色多普勒和频谱多普勒超声对肾动脉狭窄的筛查诊断价值。方法：应用彩色多普勒和频谱多普勒超声分别测量17例肾动脉狭窄患者的33支肾动脉（其中21支肾动脉狭窄）和18例无肾动脉狭窄的高血压病患者的36支肾动脉的主干峰值流速（Vmax）、肾动脉与腹主动脉峰值流速比值（RAR）和肾脏大小,并与肾动脉造影或CTA结果进行对比分析。结果：17例肾动脉狭窄患者的21支肾动脉Vmax≥180cm／s,RAR≥1．5,并且Vmax、RAR与肾动脉狭窄程度呈正相关;以Vmax≥210cm／s诊断狭窄率≥50％的肾动脉狭窄,敏感性为88％,特异性为75％,诊断准确性为86％。结论：多普勒超声可以准确诊断肾动脉狭窄,并可判断狭窄程度,可以作为高血压病患者有无肾动脉狭窄的筛查诊断方法。     

高频彩超检查在乳腺肿块中的应用效果

目的探讨高频彩超检查在乳腺肿块中的应用效果。方法选取2014年1月—2016年5月绵阳市中医院收治的乳腺肿块患者100例。所有患者均采用彩色超声诊断仪进行检查。观察所有患者病理学检查与高频彩超检查结果,比较良性乳腺肿块与恶性乳腺肿块患者二维声像学特征和彩色多普勒血流特征。结果病理学检查结果:100例患者中乳腺纤维腺瘤26例,乳腺增生结节24例,乳腺癌22例,囊肿17例,炎性包块11例。高频彩超检查结果:100例患者中乳腺纤维腺瘤26例,乳腺增生结节22例,乳腺癌25例,囊肿19例,炎性包块8例。良性乳腺肿块与恶性乳腺肿块患者轮廓形态、内部回声、微小钙化、后方回声、纵横径比比较,差异有统计学意义(P0.05)。良性乳腺肿块与恶性乳腺肿块患者血流分级、阻力指数(RI)值比较,差异有统计学意义(P0.05)。结论高频彩超检查在乳腺肿块中的应用效果较好。     

Diagnosis of thyroid follicular carcinoma by the vascular pattern and velocimetric parameters using high resolution pulsed and power Doppler ultrasonography

The aim of this study was to define the preoperative diagnosis of thyroid follicular carcinoma by the vascular pattern and velocimetric parameters using high resolution pulsed and power Doppler ultrasonography (US). We compared the vascular pattern and the velocimetric parameters, such as peak systolic velocity (Vmax), end-diastolic velocity (Vmin), pulsatility index (PI), or resistance index (RI) between follicular adenoma (FA, n = 25) and follicular carcinoma (FC, n = 10) and analysed them by means of receiver characteristics curves (ROC). Of 10 patients with FC, 8 (80%) patients presented a moderate increase of intranodular vascularization using power Doppler US. In contrast, the majority (84%, 21 out of 25 cases) of FA cases showed only a peripheral rim of color flow even by power Doppler US. These color flow imagings by power Doppler US were suggested to be a reliable tool for the differential diagnosis of thyroid follicular tumor with a sensitivity of 87.5% and a specificity of 92%. In velocimetric analyses, the Vmax/Vmin ratios, PI, and RI were significantly higher in the patients with FC than those with FA (p<0.001, p<0.005, and p<0.001, respectively). By means of ROC, FC could be diagnosed with a cutoff value of ratio of PI (>1.35), RI (>0.78), and Vmax/Vmin (>3.79). The diagnostic efficiency evaluated by ROC curves were 0.898 for PI, 0.876 for RI, and 0.888 for Vmax/Vmin, respectively. In conclusion, the evaluation of the vascular pattern and the velocimetric parameters using pulsed and power Doppler ultrasound may provide important information that is useful in making correct differential diagnosis of malignant or benign thyroid follicular tumor preoperatively.     

高频彩色多普勒超声检查早期诊断甲状腺微小乳头状癌的临床价值

目的 探讨高频彩色多普勒超声检查诊断甲状腺微小乳头状癌的临床价值.方法 回顾性分析经手术和病理证实的99例甲状腺微小乳头状癌的二维声像图及高频彩色多普勒血流分布特点.结果 甲状腺微小乳头状癌声像图表现为边缘不规则,边界不清,低回声,部分结节内微钙化,侵犯甲状腺被膜,彩色多普勒显示结节内血流信号丰富,频谱呈高速高阻型,颈部淋巴结转移.结论 二维超声声像图结合彩色多普勒血流成像及颈部淋巴结检测,能明显提高甲状腺微小乳头状癌的检出率.     

肝硬化患者拇指动脉彩色多普勒超声分析

目的：探讨肝硬化患者拇指动脉管径和血流动力学改变。方法：采用彩色多普勒超声检测60例肝硬化患者拇指动脉的管径、血管收缩期最高血流速度（Vmax）、舒张末期最低血流速度（Vmin）及阻力指数（RI）。结果：肝硬化患者拇指动脉的内径增宽、Vmax增高，失代偿期肝硬化患者的Vmin降低，与正常组比较，P〈0．05；有肝掌的肝硬化患者拇指动脉内径明显增宽、Vmin明显减缓，与无肝掌的患者比较，P〈0．05。结论：肝硬化患者存在外周血管扩张和心输出量增加的改变，失代偿期患者的血液淤滞状态更为明显；有肝掌的肝硬化患者更易出现失代偿改变。     

彩色多普勒超声检查在甲状腺恶性肿瘤的诊断价值

目的分析彩色多普勒超声检查在甲状腺恶性肿瘤的诊断价值。 方法研究共纳入38例患者观察对象,均是肇庆市第二人民医院2018年1月至2020年12月收治的经手术病理学检查确诊的甲状腺恶性肿瘤患者,38例患者均接受彩色多普勒超声检查。将手术病理学检查结果作为参照,观察彩色多普勒超声检查的结果。 结果38例患者经彩色多普勒超声检查后,有2例误诊甲状腺结节,6例漏诊,余下30例诊断为甲状腺恶性肿瘤,诊断准确率为78.95%(30/38)。38例患者主要超声表现为低回声结节,内部结构较甲状腺周围正常组织的密度高,血流量丰富,边界欠规整。 结论彩色多普勒超声检查用于甲状腺恶性肿瘤的诊断价值显著,可以为甲状腺恶性肿瘤提供良好的诊断依据,提高诊断准确率。     

Increasing incidence and characteristics of differentiated thyroid cancer in Huntington, West Virginia.

Since 1985, we have observed an increasing number of differentiated thyroid cancer cases in Huntington, West Virginia. We describe tumor incidence, patient and tumor characteristics, treatment modalities, and tumor recurrence and death. One hundred seventeen patients with differentiated thyroid cancer were identified between 1976 and 1999. Data were collected from patient records in our practice and the tumor registries at the three hospitals serving our community. The annual incidence of differentiated thyroid cancer increased significantly from fewer than 3 cases per 100,000 prior to 1996 to 9.4 cases per 100,000 in 1999. The median age at diagnosis was 49 years (range, 16-80). The median tumor size was 2.5 cm (range, 1.2-10). Forty-seven percent of the patients had bilateral disease, 28% had three or more tumors, 44% had thyroid capsular invasion, and 16% had gross extrathyroid invasion at surgery. Twenty-two percent had cervical lymph node involvement and 9% had distant metastases at diagnosis. During 1-month to 23-year follow-up, 11% had recurrence, and 5% died of thyroid cancer. In summary, differentiated thyroid cancer has increased dramatically in our community. The tumors appear to be aggressive at diagnosis as reflected by the high percentage of tumors with bilateral, multicentric, and locally invasive disease.     

Characteristics of follicular cell-derived thyroid carcinomas occurring after external radiation exposure: results of a case control study nested in a cohort.

Radiation exposure is the only well-established risk factor for follicular cell-derived thyroid carcinoma. To compare the clinical characteristics and outcome of thyroid carcinoma in patients with and without a history of radiation exposure, we performed a case control study nested in a cohort of 2,196 patients treated for a papillary or a follicular thyroid cancer at the Institut Gustave Roussy. The study was performed on 91 cases (71% females) and their 273 controls matched for gender, age at thyroid cancer diagnosis (+/-3 years), and period of initial thyroid cancer treatment (+/-6 years). More than 85% of the cases have been first exposed to external radiation before the age of 30 years. Thyroid cancers were more frequently multifocal in cases than in controls (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.3-4.8), and local residual tumor was more frequently observed in cases, but the other clinical features did not differ overall. Female cases with a history of radiation exposure more frequently had a tumor of follicular histology than female controls (OR = 2.7, 95% CI: 1.1-6.5), and conversely the frequency of follicular histology was similar in male cases and in male controls (OR = 0.3, 95% CI: 0.1-1.4). The risks of recurrence and of thyroid cancer related death were similar in cases and in controls.     

高频超声对甲状腺肿块良恶性的临床诊断价值

目的 分析甲状腺肿块的二维声像图特点及多普勒检查中的血流峰值变化,探讨高频超声对甲状腺肿块的良恶性诊断价值.方法 收集80例病人的104个甲状腺肿块声像图,根据二维声像图中肿块的形态、边界、侧壁回声失落或后方回声衰减、内部回声、微小钙化及多普勒检查中的收缩期血流峰值(Vmax)和阻力指数(RI),将肿块预期分为良性和恶性两组,将高频超声预期结果与术后病理结果进行对比,比较二者的符合率和误差率.结果 高频超声预测良性肿块66个,病理检查为61个,二者的符合率为92.4%;预测恶性肿块为38个,病理检查为32个,二者的符合率为84.2%;预测总符合率为89.4%(93/104),误差率为11.6%(11/104).结论 根据高频超声检测甲状腺肿块的声像图特点,能对甲状腺肿块的良恶性进行初步判断,对患者及临床治疗有重要的意义.

Abstract：

Objective To detect and analyze thyroid tumor by two-dimensional sonogram and Doppler parameter, and evaluate the value of high-frequency ultrasound in diagnosing thyroid benign and malignant tumors. Methods The ultrasonic images of 104 thyroid tumor from 80 patients with typical features were collected. Thyroid tumor was classified into benign and malignant nodules, based on the shape, border, or the rear wall echo, echo attenuation loss, internal echo, and microcalcifications in two-dimensional sonogram and systolic blood peak velocity (Vmax) and resistant index (RI) in Doppler examination. The expected results of high frequency ultrasound were compared with pathological results on consistency and error rate. Results Prediction of benign tumor by high frequency ultrasound was 66, and pathology 61, consistency rate of the two was 92.4%. Prediction of malignant lesions was 38, and pathological examination 32, consistency rate of the two was 84.2%. The total coincidence rate was 89.4%(93/104) and the error rate was 11.6%( 11/104). Conclusions The typical features of thyroid tumor on high-frequency ultrasound are helpful in diagnosis of benign or malignant nodules, which is valuable in guiding clinical treatment.     

黏附分子CD44变异剪接体6在甲状腺肿瘤中的表达及其临床意义

目的　探讨CD44变异剪接体 6(CD44V6 )在甲状腺肿瘤组织的表达情况及其与肿瘤发生、发展、浸润和转移的关系。方法　采用免疫组织化学S P法检测 2 0例癌旁甲状腺组织 ,2 4例甲状腺腺瘤和 64例甲状腺癌的石蜡标本CD44V6 表达水平。结果　CD44V6 在甲状腺腺癌的表达率 ( 92 19%)显著高于甲状腺腺瘤者 ( 5 8 3 3 %,P <0 0 1) ,癌旁甲状腺组织未见表达。甲状腺中不同组织来源的滤泡细胞癌和髓样癌的CD44V6 表达差异具有显著性 ,总阳性率分别为 96 5 5 %及 5 0 0 %(P <0 0 1)。但CD44V6 表达水平在乳头状腺癌和滤泡型腺癌间差别无显著性 (P >0 0 5 )。同时发现 2例未分化癌CD44V6 表达均呈强阳性。CD44V6 的表达水平与甲状腺癌的包膜浸润和淋巴结转移有关 ,CD44V6 表达水平在包膜浸润组和未浸润组之间 ,在淋巴结转移组和非转移组之间差别有显著性 (P <0 0 1)。CD44V6 表达与患者年龄、性别、肿瘤的大小无关 (P >0 0 5 )。结论　CD44V6 的表达与甲状腺肿瘤的分化和浸润、转移显著相关 ,检测CD44V6 有助于甲状腺癌的诊断、判断预后并可能为甲状腺癌的手术和术后综合治疗决策提供新的分子生物学指标。     

黏附分子CD44变异剪接体6在甲状腺肿瘤中的表达及其临床意义

目的探讨CD44变异剪接体6(CD     

A case of lung cancer with hyperthyroidism]

We here report a case of metastasis from lung cancer to the thyroid. On presentation, this patient showed painful anterior cervical swelling and right supraclavicular lymph node swelling. Laboratory data showed primary hyperthyroidism. Although subacute thyroiditis was suspected, echo-guided needle aspiration biopsy and lymph node biopsy revealed poorly differentiated squamous cell carcinoma. As a result, primary lung cancer with thyroid metastasis was diagnosed based on mediastinal enlargement on chest X ray films and normal findings in organs other than the lung and thyroid. Chemotherapy for lung cancer induced a decrease in the size of tumor and the normalization of thyroid function. However, 2 months after the normalization, cervical swelling enlarged and a lung mass in right upper lobe and skin tumor appeared. Despite treatment with chemotherapy, she died. Postmortem revealed that the right upper lung carcinoma was the primary lesion and immunohistochemical staining for surfactant protein was positive in the thyroid, skin tumor and lymph node, which revealed these carcinomas had metastasized from lung cancer. To the best of our knowledge, thyrotoxicosis induced by thyroid metastasis of lung cancer is an uncommon case.