目的 探讨彩色多普勒超声对甲状腺结节良恶性鉴别诊断价值.方法 128例甲状腺结节患者(128个结节)行彩色多普勒超声检查,以病理检查结果为金标准,将其分为良性结节组与恶性结节组,对比两组彩色多普勒超声各参数的差异,并绘制受试者工作曲线(ROC)曲线分析各参数的诊断效能.结果 128个甲状腺结节术后病理检查诊断为良性结节97个,恶性结节31个;彩色多普勒超声诊断良性结节92个,恶性结节36个,其诊断的敏感性为90.3%,特异性为91.8%.恶性结节组的微钙化灶、血流分级、边缘模糊、蟹足样、有包膜侵犯等超声参数比例均高于良性结节组(P<0.05).超声病灶血流分级、边缘分级诊断甲状腺良恶性结节的ROC曲线下面积分别为0.855、0.873,灵敏度分别为83.9%、87.1%,特异度分别为84.5%、85.6%.结论 彩色多普勒超声对甲状腺结节良恶性的鉴别诊断具有重要价值.%Objective To investigate the value of color Doppler ultrasound in the the differential diagnosis of benign and malignant thyroid nodules.Methods A total of 128 patients(128 nodules) with thyroid nodules received color Doppler ultrasound examination. Using the pathological results as golden standard,the patients were divided into benign nodule group and malignant nodule group. The parameters of color Doppler ultrasound were compared between the two groups,and the receiver operating characteristic(ROC) curve was drawn to analyze the diagnostic efficiency of each parameter.Results Of the 128 thyroid nodules,there were 97 benign and 31 malignant nodules diagnosed by postoperative pathological examination;and 92 benign and 36 malignant nodules diagnosed by color Doppler ultrasound,with the diagnostic sensitivity and specificity of 90.3% and 91.8% respectively.The proportions of microcalcification,blood flow gradation, margin haze,crab-like sign and capsular invasion in the malignant nodule group were higher than those in the benign nodule group (P<0.05).The areas under ROC curve for focal blood flow and margin gradation in the diagnosis of benign and malignant thyroid nodules were 0.855 and 0.873 respectively,the sensitivities were 83.9% and 87.1% respectively,and the specificities were 84.5% and 85.6% respectively.Conclusion Color Doppler ultrasound is of great value in the differential diagnosis of benign and malignant thyroid nodules.
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