Spiezia S, Colao A, Assanti A P, Cerbone G, Picone G M, Merola B, Lombardi G
Divisione di Chirurgia d'Urgenza e P.S., Ospedale Santa Maria del Popolo e degli Incurabili, Napoli.
Radiol Med. 1996 May;91(5):616-21.
The aim of this study was twofold: first, to improve the predictive value of ultrasonography (US) in differentiating benign from malignant thyroid nodules and, second, to investigate whether color Doppler and power Doppler can distinguish different morpho-hemodynamic patterns of hypoechoic thyroid nodules according to their vascularity. Twenty-nine patients with hypoechoic thyroid nodule(s) were entered into this work in progress. Three typical power Doppler patterns were recorded and compared with color Doppler patterns and with cytologic and/or histologic findings. Power Doppler patterns were classified as follows: type A, a perilesional vascular halo; type B, a peri- and intralesional vascular halo, subdivided into: 1) with moderate intralesional vascularization, homogeneous structure and regular vessel caliber and 2) with rich intralesional vascularization, anarchical structure and winding vessel caliber and flow; type C, a perilesional vascular halo with a characteristic peripheral large afferent vessel characterized by winding caliber and flow. Of 29 patients, 21 had type A power Doppler (benign nodular goiter at cytology, in 4 of them with regressive phenomena); seven patients had type B power Doppler patterns-4 had a subtype 1 pattern (3 with nodular hyperplasias and 1 with a papillary adenoma), 3 had a subtype 2 (two had a follicular adenoma and one had a final diagnosis of angioinvasive follicular carcinoma). The patient with undifferentiated carcinoma had a type C power Doppler pattern. In conclusion, according to our early results, PD seems to be more sensitive and reliable than CD in the screening of thyroid nodules, and to yield better vascular information.
第一，提高超声检查（US）鉴别甲状腺良恶性结节的预测价值；第二，研究彩色多普勒和能量多普勒能否根据低回声甲状腺结节的血管情况区分不同的形态血流动力学模式。29例有一个或多个低回声甲状腺结节的患者纳入了这项正在进行的研究。记录了三种典型的能量多普勒模式，并与彩色多普勒模式以及细胞学和/或组织学结果进行比较。能量多普勒模式分类如下：A型，病灶周围血管晕；B型，病灶周围和内部血管晕，再细分为：1）内部血管化中等，结构均匀，血管口径规则；2）内部血管化丰富，结构紊乱，血管口径和血流迂曲；C型，病灶周围血管晕，伴有一条特征性的外周大传入血管，其口径和血流迂曲。29例患者中，21例为A型能量多普勒（细胞学诊断为良性结节性甲状腺肿，其中4例有退行性改变）；7例患者为B型能量多普勒模式——4例为亚型1模式（3例为结节性增生，1例为乳头状腺瘤），3例为亚型2（2例为滤泡性腺瘤，1例最终诊断为血管浸润性滤泡癌）。未分化癌患者为C型能量多普勒模式。总之，根据我们的早期结果，在甲状腺结节筛查中，能量多普勒似乎比彩色多普勒更敏感、更可靠，并且能提供更好的血管信息。
