高频及彩色多普勒超声对甲状腺癌的诊断分析

甲状腺癌高频超声表现特征分析【摘要】目的研究甲状腺癌二维和彩色多普勒图像特点。

探讨对其早期诊断的可行性。

方法对我院2007年1月到2009年12月经手术病理结果证实的30例甲状腺癌患者的术前超声检查结果进行分析。

结果本组病例中单发者19 例,合并结节性甲状腺肿8例,合并腺瘤3 例。

肿瘤呈不均匀低回声26 例, 形态不规则22例,内显示钙化19 例,出现液化5 例。

显示丰富血流者16 例,显示棒条状血流信号8 例,难以显示血流信号6例。

脉冲多普勒显示平均血流速度27 cm/s。

阻力指数平均0. 65 。

结论甲状腺癌高频超声具有特征性表现,是诊断甲状腺癌的一种重要方法。

【关键词】甲状腺癌; 超声图像特征;彩色多普勒,【中图分类号】r736.1 【文献标识码】 b 【文章编号】1005-0515(2010)006-004-02analysis of high frequency ultrasonic characteristics of thyroid carcinoma[ abstract] objective to study the two dimensional and color doppler ultrasonic image characteristics of thyroid . methods making a analysis to the pre-operational ultrasonic characteristics of the 30 patients with thyroid carcinoma of which were confirmed by pathology during 1st,2007 to12th,2009 at my hospital. results 19 patients had single lump, 8 with nodular goiter, 3 with adenoma. 26 patients’ lumpswere low heterogeneous echo, 22 patients’ lump were abnormity, 19 patient s’ had calcification, 5 patient s’ had liquescence.16 patient s’ had abundant blood flow, 8 patient s’ showed “stick and strip like”blood flow, 6 patient s’ had no blood signal. the pulse doppler showed that the average blood flow velocity was 27 cm/ s. the average resistance index was 0.65. conclusion high frequency ultrasonic of thyroid carcinoma have special characteristics , it is a important way to diagnose thyroid carcinoma .[ key words] thyroid neoplasm ; ultrasonic image characteristics, doppler, color甲状腺癌在检查中较易漏诊,为探讨对其早期诊断的可行性,对甲状腺癌二维和彩色多普勒图像特点进行回顾性分析。

第21卷第8期2012年8月武警后勤学院学报（医学版）Journal of Logistics University of CAPF(Medical Sciences)vol.21No.8Aug.2012doi:10.3969/j.issn.2095-3720.2012.08.016丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐论著［收稿日期］2011-10-10;［修回日期］2012-02-21［作者简介］荀小青（1955-），女，本科，副主任医师，主要从事超声医学工作。

高频彩色多普勒超声在甲状腺癌诊断中的应用价值荀小青，赵鑫，张红（武警后勤学院附属医院超声科，天津300162）摘要：【目的】探讨高频超声检查在诊断甲状腺癌中的应用价值,总结甲状腺癌超声图像特征。

【方法】观察56例甲状腺癌患者的二维超声表现、彩色多普勒血流特征以及颈部淋巴结的转移情况，并与手术及病理结果对照分析。

【结果】超声检查56例甲状腺癌患者，发现69个病灶，检出率为100%，以病理诊断为标准，超声和病理诊断的符合率为87.5%，术前超声未明确诊断为12.5%。

甲状腺癌二维超声图像表现的特征是类圆形或椭圆形，边缘不规则，无包膜，常呈毛刺状或分叶状，甲状腺微小癌实质为不均匀低回声，纵横比大于1，较大结节可为低回声或中等回声，癌结节内常可见簇状分布的细小点状砂粒样钙化体，彩色多普勒显示结节周边及内部可见条状、短棒状及分支状血流信号，54例患者肿瘤内脉冲多普勒可探测出高阻力搏动性动脉频谱。

36例患者伴有颈部淋巴结转移，占64.3%。

【结论】高频彩色多普勒超声显像对甲状腺癌检出率高，能充分显示肿瘤的二维图像特征、血流分布状态及颈部淋巴结转移情况，应作为甲状腺癌筛查及术前检查的首选方法。

关键词：高频超声；彩色多普勒；甲状腺癌【文章编号】2095-3720(2012)08-0628-03【中图分类号】R445.1【文献标识码】AThe value of high frequency color Doppler ultrasonography in diagnosis of thyroid carcinomaXUN Xiao-qing，ZHAO Xin，ZHANG Hong （Department Of Ultrasound,Affiliated Hospital of Logistics University of Chinese People's Armed Police Force，Tianjin 300162，China ）Abstract:【Objective 】To investigate the value of ultrasonography in diagnosis of thyroid carcinoma,and summary the ultrasonography features of thyroid carcinoma.【Methods 】The two-dimensional ultrasound performances 、colorful Doppler blood flow and the cervical lymph node metastasis features were observed in 56cases with thyroid carcinoma,and compared with operations and postoperative pathologic results.【Results 】After examining of 56cases of thyroid carcinoma patients,the result found in 69lesions,the detection rate was 100%,take the pathological diagnosis as standard,the ultrasonic and pathological diagnosis were 87.5%.The two-dimensional ultrasound specific performances of 56cases with thyroid carcinoma included round-like or oval shape、irregular border、no peplos、border with burr or lobulated shape.Tiny cancers in thyroid showed heterogeneous hypoechoic、aspect ratios>1,larger nodules showed hypoechoic or isoechoic.The nodules accompanied with clumps of small point-like sand-like calcifications.Short clubbed or branching of blood flow could be found in the surrounding or internal parts of tumors on colorful Doppler.High-resistance pulsatile artery spectrum could be detected in the nodules on pulse Doppler of 54patients.36patients with cervical lymph node metastasis,accounted for 64.3%.【Conclusions 】Hyper-frequency colorful Doppler ultrasonography has high detection rate in thyroid carcinoma,can fully represent the two-dimensional ultrasound feature、blood flow distribution and cervical lymph node metastasis of tumor,it should be the preoperative preferred examination of thyroid carcinoma.Key words:Hyper-frequency ultrasound;Colorful Doppler;Thyroid carcinoma甲状腺恶性肿瘤早期无特征性临床表现，其特点为原发肿瘤的隐匿，常与其它甲状腺疾病并存，是临床诊断的难题，易造成漏诊，并且误诊率高。