结节性甲状腺肿与甲状腺腺瘤的彩色多普勒超声鉴别诊断价值探讨

目的探讨彩色多普勒在结节性甲状腺肿与甲状腺腺瘤鉴别诊断中的应用价值。方法选取2010年5月-2011年6月我院收治的经彩色多普勒诊断及手术病理证实的108例患者，分为甲状腺腺瘤组和结节性甲状腺肿组，应用彩色多普勒超声检查进行诊断并与术后病理诊断结果进行对比分析。结果比较两组患者甲状腺及结节的基本形态发现：两组患者在甲状腺和结节大小、结节位置、结节内部及周围情况等方面，差异均无显著性fP〉0．05），结节性甲状腺肿以单发为主，其周围组织回声多增强，多无边缘晕环，甲状腺腺瘤以多发为主，其其周围组织回声多正常，多有边缘晕环，差异均有显著性（P〈0．05）。两组间患者彩色多普勒血流显像比较发现：结节性甲状腺肿其结节内部及周边血流信号分级多在II级以下，而甲状腺腺瘤多在II级以上，差异具有显著性（P〈0．05）。血流频谱比较发现：结节性甲状腺肿其结节周边血流的参数（Vmax）和（Vmin）均明显低于甲状腺腺瘤，差异具有显著性（P〈0．05），而两组间患者在结节内部血流参数差异无显著性（P〉0．05）。甲状腺腺瘤组和结节性甲状腺肿组彩色多普勒超声诊断与术后病理诊断符合率分别为86％、82％。结论甲状腺腺瘤及结节性甲状腺肿在彩色多谱勒超声鉴别诊断中有较高的临床价值，临床工作中注意区分两者在彩色多谱勒超声检查中的不同表现特征，可将其作为鉴别两者最简捷且有效的检查方法。

Application of Color Doppler Ultrasound in Diagnosis of Thyroid Adenoma and Nodular Goiter

Objective To evaluate the clinical value of color Doppler ultrasonic diagnosis on thyroid adenoma and nodular goiter. Methods The ultrasonic manifestation of 50 thyroid adenoma and 58 nodular goiter were reviewed and compared with pathology finding. Results There was no significant difference between two groups when compared with the size, internal echo nodules, nodules around the capsule （P〉 0.05）, but there was a significant difference in the number of nodules, colon section size of edge halonodules （P〈 0.05）. There was a significant difference in the surrounding blood flow signals and the parameters of peripheral blood flow （Vmax） and （Vmin） between two groups （P 〈 0.05）. There was no significant difference in the parameters of internal blood flow （Vmax）, （Vmin） and RI between two groups （P〉 0.05）. The accuracy of diagnosis for thyroid adanoma and nodular goiter by color Doppler were 86% and 82% respectively. Conclusion The color Doppler ultrasound has important clinic value in the differential diagnosis of thyroid adenoma and nodular goiter.