彩色多普勒超声在甲状腺良恶性结节诊断中应用价值.docVIP

彩色多普勒超声在甲状腺良恶性结节诊断中应用价值 　　[摘要] 目的 通过总结甲状腺良、恶性结节彩色多普勒超声特征，评价其在甲状腺良、恶性结节诊断中的应用价值。方法 通过对2013年1月―2016年12月间的95例经病理证实的甲状腺结节患者（112个结节）彩色多普勒超声诊断资料的总结，比较良、恶性结节的数量、形态、边界、纵横比、内部结构、回声、钙化和结节内部及周边血流情况。结果112个甲状腺结节经病理诊断，其中93个为良性结节，19个为恶性结节。彩色多普勒超声检查的特异性为87.09%，敏感性为78.95%，诊断符合率为85.71%。良、恶性结节观察要素比较，其中两种性质结节的形态比较差异无统计学意义（P0.05）；但在边界、纵横比、内部结构、回声及钙化方面，比较差异有统计学意义（P0.01）。彩色血流信号分级方面，良性结节主要表现为0级和Ⅰ级，恶性结节主要表现为Ⅱ级和Ⅲ级，比较差异有统计学意义（P0.01）。良性结节动脉收缩期峰值血流速度、阻力指数低于恶性结节（P0.01），舒张末期血流速度高于恶性结节（P0.01）。 结论 彩色多普勒超声在甲状腺良、恶性结节的诊断中具有较高敏感性和特异性，可作为首选影像学检查方法。 　　[关键词] 彩色多普勒超声；甲状腺结节；诊断；影像学 　　[中图分类号] R445.1 [文献标识码] A [文章编号] 1674-0742（2017）08（a）-0181-04 　　[Abstracts] Objective This paper tries to analyze the ultrasonographic features of benign and malignant thyroid nodules and to evaluate the clinical applications of color doppler ultrasonography. Methods The color doppler ultrasonography data of 95 patients with thyroid nodules （112 nodules） confirmed by pathology from January 2013 to December 2016 were summarized， and the number， shape， aspectratio， internal structure and echo， calcification， internal and peripheral blood flow of thyroid nodules were compared between benign and malignant nodules. Results Of 112 nodules confirmed by pathology， there were 93 benign nodules and 19 malignant nodules. The specificity， sensitivity and diagnostic accordance rate of color doppler ultrasonography was 87.09%， 78.95% and 85.71% in the diagnosis of benign and malignant thyroid nodules. The difference of shape between benign nodules and malignant nodules was not statistically significant（P0.05）. But benign nodules boundary， aspect ratio， internal structure and echo， calcification were all significantly different from malignant nodules （P0.01）. The signal grade of color doppler blood flow， malignant nodules was mainly gradeⅡand Ⅲ， while benign nodules was mainly grade 0 andⅠ， the difference was statistically significant （P0.01）. Benign nodules of peak systolic velocity （PSV） and resistance index （RI） were significantly lower