CAJ | 학술논문

目的：探讨超声图像对结节性甲状腺肿伴甲状腺癌的诊断价值。方法：选择2010年6月至2012年8月就诊的216例甲状腺肿的患者作为研究对象，进行二维超声、彩色多普勒超声检查以及病理组织活检等。结果：超声诊断的结果准确率为54.72％。术前超声诊断的结果显示，58例为结节性甲状腺肿合并甲状腺癌，恶性结节共104个；158例为结节性甲状腺良性结节，良性结节共296个。术后活组织病理检查显示，106例患者为结节性甲状腺肿合并甲状腺癌，恶性结节共为172个；110例为结节性甲状腺良性结节，良性结节共208个。两组超声图像上结节的回声、形态以及钙化情况比较，差异有统计学意义( P<0.05)。恶性结节血流多为Ⅱ级以上，而良性结节血流多为Ⅰ级和Ⅱ级，两者的血流分级情况比较，差异有统计学意义( P<0.05)。结论：二维超声及彩色多普勒检查对结节性甲状腺肿合并甲状腺癌患者的诊断检出率较高，进行超声检查时应重点扫描结节的回声、钙化情况、周边及内部的血流等等，如有必要，可进行超声引导下的穿刺病理组织活检，提高诊断的准确性。
목적：탐토초성도상대결절성갑상선종반갑상선암적진단개치。방법：선택2010년6월지2012년8월취진적216례갑상선종적환자작위연구대상，진행이유초성、채색다보륵초성검사이급병리조직활검등。결과：초성진단적결과준학솔위54.72％。술전초성진단적결과현시，58례위결절성갑상선종합병갑상선암，악성결절공104개；158례위결절성갑상선량성결절，량성결절공296개。술후활조직병리검사현시，106례환자위결절성갑상선종합병갑상선암，악성결절공위172개；110례위결절성갑상선량성결절，량성결절공208개。량조초성도상상결절적회성、형태이급개화정황비교，차이유통계학의의( P<0.05)。악성결절혈류다위Ⅱ급이상，이량성결절혈류다위Ⅰ급화Ⅱ급，량자적혈류분급정황비교，차이유통계학의의( P<0.05)。결론：이유초성급채색다보륵검사대결절성갑상선종합병갑상선암환자적진단검출솔교고，진행초성검사시응중점소묘결절적회성、개화정황、주변급내부적혈류등등，여유필요，가진행초성인도하적천자병리조직활검，제고진단적준학성。
Objective:To determine the diagnostic value of ultrasonography in patients with nodular goiter who had thyroid carcinoma.Methods:Between June 2010 and August 2012,we recruited 216 patients with goiter who underwent the two dimensional ultrasonography, color Doppler ultrasonography and pathologic biopsy. Results:Ultrasonography yielded an accuracy of 54.72%. Preoperative ultrasonography showed that 58 cases with nodular goiter and thyroid cancer had 104 malignant nodules and that 106 cases with nodular thyroid benign nodules yielded a total of 296 benign nodules. Tissue biopsy showed that 106 patients with nodular thyroid benign nodules and thyroid cancer yielded 172 malignant nodules and that 110 cases with nodular thyroid benign nodules had a total of 208 benign nodules. The differences in echoes, morphology and calcification between both groups were statistically significant (all P<0.05). Malignant nodules were associated with grade 2 hemodynamics and benign nodules grades 1 or 2 hemodynamics ( P<0.05) . Conclusion:Two-dimensional ultrasonography and color Doppler ultrasonography have a high sensitivity in patients with nodular goiter and thyroid cancer. More attention should be paid to the nodular echoes, calcification and peripheral and internal blood flow when performing ultrasonography. The addition of ultrasound-guided puncture for biopsy, if indicated, may be associated with improved diagnostic accuracy.