甲状腺乳头状癌的彩色多普勒超声血流特点

目的：探讨甲状腺乳头状癌的彩色多普勒超声（CDFI）血流表现的特点。方法：回顾性分析经术后病理证实的88例甲状腺乳头状癌患者的彩色多普勒超声图像，观察病灶内部回声，有无钙化，血流分布特点、血流形态，测量肿瘤内部血管阻力指数（RI），收缩期峰值流速（Vmax），并分析频谱的形态。结果：甲状腺乳头状癌结节内多为高血供（81．8％），而微钙化与结节内部丰富血流同时出现具有特征性。甲状腺乳头状癌结节以结节内部血流为主（68．7％），血流分布异常杂乱，结节内部更低回声区团块状异常丰富血流及无级别差异的分支血管的出现可提高对甲状腺乳头状癌的诊断。频谱多普勒峰值血流多出现于收缩期上升支的前1／3，RI〉0．7可作为甲状腺结节良恶性鉴别的指标。颈部转移淋巴结CDFI多为包膜下异常紊乱血流信号，并向内部分支，其血流丰富程度及血流形态与甲状腺内原发病灶相似。结论：甲状腺乳头状癌的彩色多普勒血流表现有一定的特点，将其与二维声像图结合可提高甲状腺乳头状癌的诊断率。

Blood Flow Features of Thyroid Papillary Carcinoma In Color Doppler Ultrasound

Objective：To investigate the thyroid papillary carcinoma＇s blood flow features of Color Doppler Flow Imaging （CDFI）. Methods： Sonograms of 88 patients with thyroid papillary carcinoma proved by pathology were retrospectively analyzed. Observation was made on the internal echo, calcification, characteristics of flow distribution, and also the blood flow morphology. The tumor＇s resistance index （RI） and maximal velocity （Vmax） were measured and spectral shapes were analyzed. Results： Most of the thyroid papillary carcinoma showed rich blood flow signals （81.8%）. And lesions were characteristic with microcalcification and internal rich blood flow signals appearing at the same time. There was marked intranodular blood flow in most nodules （68.7% ）, and the distribution of flow was abnormal. The appearances of massive rich blood flow in hypoeehoic areas of nodules and the ramose vessels which were indiscriminate in levels could improve the diag nosis of the thyroid papillary carcinoma. Peak systolic velocity in spectrum Doppler often appeared at tile afore one/third of the systolic period,and RI〉0.7 could become a parameter in diagnosing benign and malignant thyroid nodules. The CDFI of cervical lymph node metastasis more often showed subcapsular abnormal disorder signals,which sent out branches to interior. The degree and morphology of its blood flow were similar to those of primary focus in thyroid. Conclusion：The features of thyroid papillary carcinoma＇ s blood flow in color Doppler ultrasound and their combination with the two-dimensional sonogram will improve the diagnosis rate of thyroid papillary carcinoma.