摘要
目的统计分析甲状腺占位性病变的超声图像资料,总结有价值的超声学特点,提高术前诊断准确率。方法收集2002年1月—2005年12月1700例术前超声图像资料,分析灰阶和彩色超声表现。本组病例全部经手术及病理证实。诊断良性占位性病变的依据为:①多发病灶;②病灶周边有完整“晕环”;③病灶形态规则,边界清晰,内部回声均匀;④有粗大钙化影像;⑤血流丰富程度多数为Ⅰ或Ⅳ级,血流分布多数为Ⅰ型;⑥血流阻力指数高于0·6,血流峰值速度低于12cm/s。诊断恶性占位性病变的依据为:①单发病灶;②病灶形态欠规则,边界欠清晰;③内部不均匀低回声;④有细沙粒样钙化影像;⑤血流丰富程度多数为Ⅱ或Ⅲ级,血流分布多数为Ⅱ型;⑥颈部淋巴结转移病灶;⑦血流阻力指数低于0·6,血流峰值速度高于12cm/s。结果良性病变1284例,恶性病变416例。单纯依据灰阶超声表现,诊断甲状腺良性病变准确率为80·0%,恶性准确率为75·0%。综合彩超表现,诊断良性病变准确率为86·0%,恶性准确率为82·0%,总的准确率为85·0%。结论灰阶超声特点对鉴别良、恶性非常重要,彩色超声可明显提高诊断准确率,其中血流指数测定对鉴别良、恶性病变意义不大。超声诊断甲状腺占位性病变的准确率较高,可作为术前影像检查首选方法。
Objective To analyse ultrasonographic mapping of the thyroid lesions, so as to summarize ultrasonographic characteristics, and improve the accuracy rate of preoperative diagnosis for thyroid lesions. Methods The clinical data were analyzed for 1700 patients with different thyroid lesions who were treated between January 2002 and December 2005. The appearance of gray scale and colour Doppler sonography for the lesions was prospectively studied, the different blood flow index was determined. All patients underwent surgery and had histopathologic diagnosis at Cancer Hospital, Chinese Academy of Medical Sciences. The criterion of diagnosis for benign lesions were ①muhinodular; ② the presence of peripheral halo; ③regular and defined margins, intranodular uniform echogenicity; ④ macrocalcification ; ⑤the degree of blood flow was Ⅰ or Ⅳ grade, the distribution of blood flow was Ⅰ type; ⑥the blood resistance index was over 0. 6, the blood peak value speed was below 12 cm/s. The criterion of diagnosis for malignant lesions were ①single nodular; ② irregular and partly defined margins;③intranodular irregular hypoechogenicity; ④microcalcification; ⑤ the degree of blood flow was Ⅱ or Ⅲ grade, the distribution of blood flow was Ⅱtype;⑥the presence of metastatic lymph node in region; ⑦the blood resistance index was below 0. 6, the blood peak value speed was over 12 cm/s. Results Of all cases , 1284 cases were benign and 416 cases malignant. The accuracy rate of gray scale sonography for benign and malignant thyroid lesions was respectively 80.0% and 75.0%. The accuracy rate of ultrasound diagnosis for benign and malignant thyroid lesions was respectively 86.0% and 82. 0%, total accuracy rate for thyroid lesion was 85.0%. Conclusions Gray scale sonography was very important to distinguishing between benign and malignant lesions of thyroid tumor, the accuracy rate was greatly improved with colour Doppler sonography, but the determination of blood flow index is no help to differentiating between benign and malignant lesions of thyroid tumor. The accurate rate of ultrasound for the diagnosis of thyroid lesions is high, it is the first choice measure in preoperative diagnosis for thyroid lesions.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2006年第6期415-418,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
超声检查
甲状腺疾病
诊断
Ultrasonography
Thyroid disease
Diagnosis
