多普勒超声、微细血流成像技术及VTI弹性成像技术在鉴别甲状腺良恶性结节中应用研究
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摘要
目的 :分析多普勒超声(CDFI)、微细血流成像技术(SMI)及声触诊组织成像技术(VTI)在甲状腺良恶性结节鉴别中的临床价值。方法 :收集我院收治的54例均病理证实为甲状腺结节患者的临床资料,所有患者入院后均完成CDFI、SMI、VTI弹性成像技术检测,影像学资料完整,与病理结果对照,分析CDFI、SMI、VTI技术在鉴别甲状腺良恶性结节中的应用价值。结果 :①甲状腺良性结节血流信号以Ⅰ～Ⅱ型为主,SMI成像检出Ⅰ～Ⅱ型共45个,占86.54%,高于CDFI的63.46%,甲状腺恶性结节血流分型以Ⅲ～Ⅳ型为主,SMI检出Ⅲ～Ⅳ型共20例,占83.33%,高于CDFI的62.50%,但对比差异无统计学意义,SMI检出Ⅲ型所占比例高于CDFI;②良性甲状腺弹性成像分级中Ⅰ～Ⅲ级所占比例为88.46%,Ⅳ～Ⅵ级所占比例为83.33%;③SMI、VTI鉴别甲状腺良恶性结节准确率分别为85.53%、86.84%,均高于CDFI诊断准确率,对比差异有统计学意义。结论 :超声SMI、VTI成像技术均可提高甲状腺良恶性结节鉴别准确率,较常规CDFI优势明显。
Objective To analyze the clinical value of color Doppler flow imaging(CDFI), superfine blood flow imaging(SMI) and virtual touch tissue imaging(VTI) in the differential diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 54 patients with thyroid nodules confirmed by pathology in our hospital were collected. All patients were examined by CDFI, SMI and VTI elastography after admission. The imaging data were complete and were compared with pathological results. The value of CDFI, SMI and VTI in the differential diagnosis of benign and malignant thyroid nodules was analyzed.Results The main blood flow signal of the benign thyroid nodules was type Ⅰ～Ⅱ. There were 45 typeⅠ～Ⅱ nodules detected by SMI, accounting for 86.54%, higher than 63.46% of CDFI. The main blood type of malignant thyroid nodules was typeⅢ～Ⅳ,and there were 20 type Ⅲ～Ⅳ nodules detected by SMI, accounting for 83.33%, higher than 62.50% of CDFI. The proportion of type Ⅲdetected by SMI was higher than that of CDFI. The benign thyroid elastography gradeⅠ～Ⅲ accounted for 88.46% while grade Ⅳ～Ⅵ accounted for 83.33%. The accuracy rates of SMI and VTI in differentiating benign and malignant thyroid nodules were 85.53% and 86.84%, respectively, which were higher than that of CDFI. Conclusion Ultrasound, SMI and VTI all can improve the accuracy rate in the differential diagnosis of benign and malignant thyroid nodules, which has obvious advantages over conventional CDFI.
Objective To analyze the clinical value of color Doppler flow imaging(CDFI), superfine blood flow imaging(SMI) and virtual touch tissue imaging(VTI) in the differential diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 54 patients with thyroid nodules confirmed by pathology in our hospital were collected. All patients were examined by CDFI, SMI and VTI elastography after admission. The imaging data were complete and were compared with pathological results. The value of CDFI, SMI and VTI in the differential diagnosis of benign and malignant thyroid nodules was analyzed.Results The main blood flow signal of the benign thyroid nodules was type Ⅰ～Ⅱ. There were 45 typeⅠ～Ⅱ nodules detected by SMI, accounting for 86.54%, higher than 63.46% of CDFI. The main blood type of malignant thyroid nodules was typeⅢ～Ⅳ,and there were 20 type Ⅲ～Ⅳ nodules detected by SMI, accounting for 83.33%, higher than 62.50% of CDFI. The proportion of type Ⅲdetected by SMI was higher than that of CDFI. The benign thyroid elastography gradeⅠ～Ⅲ accounted for 88.46% while grade Ⅳ～Ⅵ accounted for 83.33%. The accuracy rates of SMI and VTI in differentiating benign and malignant thyroid nodules were 85.53% and 86.84%, respectively, which were higher than that of CDFI. Conclusion Ultrasound, SMI and VTI all can improve the accuracy rate in the differential diagnosis of benign and malignant thyroid nodules, which has obvious advantages over conventional CDFI.
引文
[1]纪莉,吴凤林,娄雪峰,等.超声弹性成像评估甲状腺良性结节射频消融效果的价值探讨[J].中国超声医学杂志, 2014, 30(12):1071-1073.
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[9]张冰,齐铮琴.超声检查联合超声弹性成像鉴别甲状腺良恶性结节的临床价值[J].河北医药, 2016, 38(16):2484-2485, 2488.
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[11]潘国强,李声,王红艳,等.超声弹性成像对Graves病与桥本甲状腺炎的鉴别意义[J].医学研究杂志, 2016, 45(2):139-142.
[12]赵敏,张步林,何冰玲,等.实时超声弹性成像与常规超声在甲状腺占位性疾病良恶性鉴别中的应用价值比较[J].广西医学, 2015,37(1):125-126.
[13]刁雪红,詹嘉,陈林,等.超级微血管成像技术在甲状腺实性结节良恶性鉴别诊断中的应用价值[J].中华医学超声杂志(电子版),2016, 13(8):622-626.
[2]温乔,李晓桐,梁平,等.甲状腺彩色超声对甲状腺良性结节与甲状腺癌的诊断价值[J].湖南师范大学学报(医学版), 2015, 12(5):80-82.
[3]庞雅平,申晶,贾贺堂,等.甲状腺恶性结节相关危险因素分析[J].解放军医药杂志, 2015, 27(7):67-69.
[4]邱华,马步云,赵萌,等.甲状腺良恶性结节超声鉴别诊断的影响因素探讨[J].西部医学, 2016, 28(4):545-547, 551.
[5]李泉水,徐细洁,陈胜华,等.超声成像结合VTI弹性成像在甲状腺良恶性结节鉴别诊断中的作用[J].中国超声医学杂志, 2016, 32(1):9-12.
[6]李玉芳,康永茂,陈春娥,等.超声弹性成像在甲状腺良恶性结节诊断中的应用[J].实用临床医药杂志, 2016, 20(5):139-141.
[7]刘伟,王英娈,郭方春,等.甲状腺滤泡状癌与甲状腺滤泡状腺瘤的超声诊断与鉴别诊断[J].西部医学, 2015, 27(4):555-557.
[8]方芹,何云,杨红,等.常规超声结合实时超声弹性成像在甲状腺结节诊断中的应用[J].广西医科大学学报, 2015, 32(6):921-923.
[9]张冰,齐铮琴.超声检查联合超声弹性成像鉴别甲状腺良恶性结节的临床价值[J].河北医药, 2016, 38(16):2484-2485, 2488.
[10]方北,李开林,聂红莲,等.超声弹性应变率比值在甲状腺良恶性结节中的鉴别诊断价值[J].医学临床研究, 2013, 30(2):220-222.
[11]潘国强,李声,王红艳,等.超声弹性成像对Graves病与桥本甲状腺炎的鉴别意义[J].医学研究杂志, 2016, 45(2):139-142.
[12]赵敏,张步林,何冰玲,等.实时超声弹性成像与常规超声在甲状腺占位性疾病良恶性鉴别中的应用价值比较[J].广西医学, 2015,37(1):125-126.
[13]刁雪红,詹嘉,陈林,等.超级微血管成像技术在甲状腺实性结节良恶性鉴别诊断中的应用价值[J].中华医学超声杂志(电子版),2016, 13(8):622-626.