Urso M, Angelillis L, Ambrosio G B
Complesso Convenzionato dell'Università degli Studi di Padova, Divisione Medica I, Ospedale Civile di Venezia.
Ann Ital Med Int. 1996 Jul-Sep;11(3):175-9.
A number of studies done with color-flow Doppler (CFD) sonography have disclosed intense vascularization of malignant thyroid nodules. As this method might be able to provide important reference data to enable differentiation between benign and malignant nodular pathology, a study of the vascularization of single thyroid nodules using CFD sonography was done at the Endocrinology Out-Patient Clinic of the Combined Units of the University of Padua and the City Hospital of Venice, 1st Medical Division. Its aim was to verify the utility of CFD in the diagnosis of solitary and scintigraphically "cold" thyroid nodules, particularly to distinguish benign from malignant nodular pathology. One hundred nineteen patients were examined with hormonal dosage, scintigraphy, fine-needle aspiration biopsy (FNAB), echography and CFD sonography of the thyroid, and, in some cases, histological examination. Nineteen patients underwent histological examination: 17 follicular adenomas and 2 papillary carcinomas were found. Color-flow Doppler sonography indicated intense intranodular vascularization in both cases of malignant neoplasm (sensitivity 100%) and in 2 cases of the 17 benign lesions (specificity 88.2%). Moreover, intralesional hypervascularization was not observed in the 2 false positive FNAB cases. Although limited by the scarcity of histological material and the absence of cases of follicular carcinoma, this study has demonstrated that CFD sonography is a highly sensitive (no false negatives) and specific (only 2 false positives) method to diagnose scintigraphically "cold" single thyroid nodules.
多项采用彩色多普勒（CFD）超声检查的研究揭示了恶性甲状腺结节的强烈血管化。由于该方法可能能够提供重要参考数据，以实现良性和恶性结节性病变的鉴别，因此在帕多瓦大学和威尼斯市立医院第一医疗科联合单位的内分泌门诊，开展了一项使用CFD超声检查单个甲状腺结节血管化的研究。其目的是验证CFD在诊断孤立性和闪烁扫描显示为“冷”的甲状腺结节中的效用，特别是区分良性和恶性结节性病变。对119例患者进行了甲状腺激素剂量测定、闪烁扫描、细针穿刺活检（FNAB）、超声检查和CFD超声检查，部分病例还进行了组织学检查。19例患者接受了组织学检查：发现17例滤泡性腺瘤和2例乳头状癌。彩色多普勒超声检查显示，在2例恶性肿瘤病例（敏感性100%）和17例良性病变中的2例（特异性88.2%）中，结节内均有强烈的血管化。此外，在2例假阳性FNAB病例中未观察到病灶内血管增生。尽管受到组织学材料稀缺以及缺乏滤泡癌病例的限制，但本研究表明，CFD超声检查是诊断闪烁扫描显示为“冷”的单个甲状腺结节的一种高度敏感（无假阴性）和特异（仅2例假阳性）的方法。
