CAJ | 학술논문

目的：探讨在甲状腺良恶性结节诊断中采用高频彩色多普勒超声检查的临床价值。方法对185例甲状腺结节患者（共369个结节）采用高频彩色多普勒超声检查，分析其影像学特点及对比良恶性结节征象。结果采用高频彩色多普勒超声检查甲状腺结节，灵敏度为97.01％，特异度为95.59％，阳性预测值为98.98％，阴性预测值为87.84％；超声检查发现，良性结节形态多规则，边界清晰，伴有或不伴有声晕，横向生长，内部回声多为中等回声、高回声、囊性无回声，多数不伴有钙化，同恶性结节相比较，差异具有统计学意义（P＜0.05）；对血流进行分析，301个良性结节中Ⅰ型血流134例，Ⅱ型血流123例，Ⅲ型血流35例，Ⅳ型血流9例，68个恶性结节中Ⅰ型血流11例，Ⅱ型血流9例，Ⅲ型血流32例，Ⅳ型血流16例，组间对比差异具有统计学意义（P＜0.05）。结论甲状腺良恶性结节声像之间有明显的差异，也存在交叉的共同表现，结节边缘成角、内部微钙化形成和颈部异常淋巴结肿大有助于甲状腺乳头状癌的诊断；甲状腺腺瘤和甲状腺滤泡状癌在声像上很相似，鉴别时需谨慎。对甲状腺结节二维及彩色多普勒血流显像进行全面综合分析，可提高结节良恶性诊断率。高频彩色多普勒超声检查在甲状腺良恶性结节鉴别诊断中具有重要价值，可作为临床首选的影像检查。
목적：탐토재갑상선량악성결절진단중채용고빈채색다보륵초성검사적림상개치。방법대185례갑상선결절환자（공369개결절）채용고빈채색다보륵초성검사，분석기영상학특점급대비량악성결절정상。결과채용고빈채색다보륵초성검사갑상선결절，령민도위97.01％，특이도위95.59％，양성예측치위98.98％，음성예측치위87.84％；초성검사발현，량성결절형태다규칙，변계청석，반유혹불반유성훈，횡향생장，내부회성다위중등회성、고회성、낭성무회성，다수불반유개화，동악성결절상비교，차이구유통계학의의（P＜0.05）；대혈류진행분석，301개량성결절중Ⅰ형혈류134례，Ⅱ형혈류123례，Ⅲ형혈류35례，Ⅳ형혈류9례，68개악성결절중Ⅰ형혈류11례，Ⅱ형혈류9례，Ⅲ형혈류32례，Ⅳ형혈류16례，조간대비차이구유통계학의의（P＜0.05）。결론갑상선량악성결절성상지간유명현적차이，야존재교차적공동표현，결절변연성각、내부미개화형성화경부이상림파결종대유조우갑상선유두상암적진단；갑상선선류화갑상선려포상암재성상상흔상사，감별시수근신。대갑상선결절이유급채색다보륵혈류현상진행전면종합분석，가제고결절량악성진단솔。고빈채색다보륵초성검사재갑상선량악성결절감별진단중구유중요개치，가작위림상수선적영상검사。
ObjectiveTo explore the clinical value of the high frequency color doppler ultrasound in the diagnosis of benign and malignant thyroid nodules.Methods 185 patients with thyroid nodules (369 nodules) were received high frequency color doppler ultrasound. Imaging features were analyzed and the signs of benign thyroid nodules and malignant thyroid nodules were compared.Results The sensitivity, specificity, positive predictive value, negative predictive value of the high frequency color doppler ultrasound in the examination of benign and malignant thyroid nodules were respectively 97.01%, 95.59%, 98.98% and 87.84%. Ultrasound examination found that benign nodules usually laterally grew with regular contour and clear boundary accompanied by internal echoes mostly including media echo, high echo and no echo and most benign nodules were non-calcified. The differences between benign thyroid nodules and malignant thyroid nodules were statistically significant (P<0.05). Blood flow was compared. The number of type Ⅰ blood flow, type Ⅱ blood flow, type Ⅲ blood flow, type Ⅳ blood flow were respectively 134, 123, 35 and 9 in the 301 cases of benign nodules. While the number of type Ⅰ blood flow, type Ⅱ blood flow, type Ⅲ blood flow, type Ⅳ blood flow were respectively 11, 9, 32 and 16 in 68 cases of malignant nodules. The difference was statistically significant (P<0.05).Conclusion There are obvious differences in the acoustic images of benign thyroid nodules and malignant thyroid nodules as well as some crossed common features. Angulated edge and internal micro calcification of nodules and abnormal lymphadenopathy of the neck is helpful in the diagnosis of papillary thyroid carcinoma. Acoustic images of thyroid adenoma and thyroid follicular cancer are extremely similar which needs to be cautious when differentiating. A comprehensive and synthetic analysis of Two-dimensional imaging and color Doppler flow imaging can improve the diagnostic rate of benign and malignant thyroid nodules. High frequency color doppler ultrasound has important value in the differential diagnosis of benign and malignant thyroid nodules which can be the preferred imaging examination in clinical practice.