甲状腺结节二维及彩色多普勒超声诊断及临床意义.docVIP

甲状腺结节二维及彩色多普勒超声诊断及临床意义 　　【摘 要】目的：对比分析甲状腺结节声像图特征，探讨超声鉴别诊断要点，从而提高诊断准确率。方法：回顾分析260例共458枚甲状腺结节的超声检查结果，观察结节的边界及形态、内部回声、纵横比、微钙化、囊变、血流信号等声像图指标，结果与病理对照。结果：多数甲状腺恶性肿瘤具有一些共同特征，病变多为低回声，内部结构较致密，有时出现点状强回声，边界不规整，彩色多普勒多为Ⅲ型。结论：超声的这些征象有助于判断良恶性，也对指导穿刺活检具有重要价值。 　　【关键词】甲状腺；甲状腺结节；甲状腺肿瘤；超声诊断 　　High-resolution Ultrasound and Color Doppler Flow Imaging Diagnosis 　　of Thyroid nodules 　　Ai Xue Zhang Guoqiang The Five Hospital of Dalian，Dalian 116021 China 　　[Abstract] Objective： To explore the ultrasound differential diagnosis of thyroid nodules and improve the diagnostic accuracy of nodules by comparing and analyzing the ultrasound images characteristics. Methods： The ultrasound data of 458 nodules from 260 patients，which were retrospectively analyzed.Observed the ultrasound images of nodules boundary and shape，internal echo，aspect radio，micro-calcification，cystic degeneration，blood flow signals，the result were compared with the pathology. Results： Many common ultrasound images characteristics were showed in most of thyroid tumors， hypoechogenicity ， more compact，nodular and irregular， micro-calcified，the nodular goiters with minimal malignancy devoid the above signs.Color Doppler showed arterial blood flow in all the tumors.The type Ⅲ pattern on CDFI was more often found in malignant nodules. Conclusions： The detection and differential diagnosis of thyroid nodules by ultrasonography is clinically valuable.The combination of conventional US characteristic and vascular pattern on CDFI in thyroid nodule can improve the accuracy of differential diagnosis and fine needle aspiration cytology diagnosis. 　　[Key words] Thyroid； Thyroid nodules； Thyroid tumors； Ultrasonography 　　目前甲状腺结节性疾病的发病率逐渐增高，随着健康体检的普遍开展，尤其是颈部高频彩超的广泛进行，甲状腺疾病的检出率大幅提高，目前影像检查中超声对甲状腺结节的敏感性最高（74%～81%）[ 1 ]，本研究采用二维及彩色多普勒超声对甲状腺结节疾病进行检查，鉴别其良恶性，对临床治疗及手术选择提供帮助。 　　1 资料与方法 　　1.1 研究对象 2010年1月至2012年9月经手术及病理证实的甲状腺结节260例共458枚，男58例，女202例，年龄25～75岁，平均（45.2±9.5）岁，因颈前不适或体检时被发现。 　　1.2 仪器与方法 采用SIEMENS Antares超声诊断仪，探头频率7.5～12MHz，声束与血流方向夹角1，否则为纵横比50%）；