彩色多普勒超声对甲状腺良恶性结节的诊断及鉴别诊断价值分析

目的探讨超声对甲状腺良恶性结节的诊断及鉴别诊断价值。方法回顾性分析2009年1月～2014年1月我院经手术病理证实的60例甲状腺良恶性结节患者的超声声像图表现及CDFI显示血流动力学参数的变化情况。结果入选的60例甲状腺结节患者中,良性病变48例（50个结节）,包括结节性甲状腺肿26例,甲状腺腺瘤22例;恶性病变12例（14个结节）,包括甲状腺乳头状癌10例,滤泡性癌1例,转移癌1例。48例良性结节的血流动力学分级0级10例,Ⅰ级30例,Ⅱ级7例,Ⅲ级1例,其中II级以下占83.3%;12例恶性结节的血流动力学分级0级0例,Ⅰ级1例,Ⅱ级3例,Ⅲ级8例,Ⅲ级占75%。恶性结节组的PSV、RI明显高于良性结节组,而恶性结节组EDV明显低于良性结节组,组间比较,差异具有显著性（P〈0.05）。结论甲状腺良恶性结节的超声诊断依据应以二维超声表现为主,结合彩色多普勒血流显像及其病理基础能提高其诊断的准确性。因此,要熟悉甲状腺结节的声像图表现及鉴别要点,且要密切结合临床资料进行综合分析,才能减少误诊的发生。

Diagnosis and differential diagnostic value of color doppler ultrasound for benign and malignant thyroid nodules

Objective To investigate the diagnosis and differential diagnosis value of benign and malignant thyroid ultrasound nodules. Methods A retrospective analysis of the sonographic manifestations and CDFI showed changes of hemodynamic parameters of 60 patients with benign and malignant thyroid nodules confirmed by pathology from January 2009 to January 2014 in our hospital. Results Sixty patients included benign lesions 48 cases（50 nodules）,26 cases nodular goiter, 22 cases thyroid adenoma; malignant lesions in 12 cases（14 nodules）, included papillary thyroid carcinoma 10 patients, follicular carcinoma 1 case, metastatic carcinoma 1 case. 48 cases of benign nodules blood dynamics grade 0 10 cases, grade Ⅰ 30 cases, grade Ⅱ 7 cases, grade Ⅲ 1 case, in which the following grade Ⅱ（83.3%）; 12 cases of malignant nodules hemodynamic classification grade 0 0 cases, grade Ⅰ 1 case, grade Ⅱ 3 cases, grade Ⅲ 8 cases, grade Ⅲ accounted for 75%. PSV, RI of malignant nodules group was significantly higher than benign nodules, EDV of malignant nodules group was significantly lower than benign nodules group, the difference was significant（P〈0.05）. Conclusion Benign and malignant thyroid nodules ultrasound diagnosis is based on two-dimensional ultrasound should be performance-based, combined with color doppler flow imaging and pathology can improve the accuracy of diagnosis. Therefore, familiar with the sonographic appearance of thyroid nodules and differential points, and closely linked to a comprehensive analysis of the clinical data, in order to reduce the incidence of misdiagnosis.