Application value of high-frequency color doppler ultrasound in the differential diagnosis of thyroid cancer
高频彩色多普勒超声在甲状腺癌鉴别诊断中的应用价值

摘要

目的 调查甲状腺癌鉴别过程中高频彩色多普勒超声的价值。方法 以30例疑似甲状腺癌患者为样本，从2021年8月入选，到2024年8月停止入选，均在该时期内行常规超声检查，而后予以高频彩色多普勒超声检查，接着参考病理活检，观察检查结果并分析其诊断效能，而后辨别影像学特征。结果 手术活检中真阳性检出率为43.33%（13/30），真阴性检出率为56.67%（17/30）；常规超声真阳性检出率为23.33%（7/30），真阴性检出率为43.33%（13/30）；高频超声真阳性检出率为40.00%（12/30），真阴性检出率为63.33%（17/30）。诊断特异度、敏感度、符合率分析中，高频彩超（92.31%、100.00%、96.67%）明显更高，而常规超声（53.85%、76.47%/66.67）偏低，P<0.05。影像学特征显示，甲状腺癌患者的边缘模糊率（61.54%）、低/极低回声率（92.31%）、结节纵横比≥1（69.23%）、形态不规则率（61.54%）、微小钙化率（61.54%）、血流分型III型率（38.46%）均高于良性甲状腺病变，P<0.05。结论 高频彩色多普勒超声的诊断效能高，其影像学特征清晰，可提升甲状腺癌的真阳性检出率。

Abstract

Objective To investigate the value of high-frequency color Doppler ultrasound in the differential diagnosis of thyroid cancer.
Methods A total of 30 patients suspected of having thyroid cancer were selected as the sample from August 2021 to August 2024. All patients underwent conventional ultrasound examination during this period, followed by high-frequency color Doppler ultrasound examination. Pathological biopsy results were then used as a reference to observe the examination outcomes and analyze their diagnostic efficacy, followed by identifying imaging features.
Results The true positive detection rate in surgical biopsy was 43.33% (13/30), and the true negative detection rate was 56.67% (17/30); for conventional ultrasound, the true positive detection rate was 23.33% (7/30) and the true negative detection rate was 43.33% (13/30); for high-frequency ultrasound, the true positive detection rate was 40.00% (12/30) and the true negative detection rate was 63.33% (17/30). In the analysis of diagnostic specificity, sensitivity, and accuracy, high-frequency color Doppler ultrasound (92.31%, 100.00%, 96.67%) was significantly higher, whereas conventional ultrasound (53.85%, 76.47%, 66.67%) was lower, P<0.05. Imaging features showed that thyroid cancer patients had higher rates of blurred margins (61.54%), low/extremely low echogenicity (92.31%), nodule length-to-width ratio ≥1 (69.23%), irregular shape (61.54%), microcalcifications (61.54%), and type III blood flow pattern (38.46%) than benign thyroid lesions, P<0.05.
Conclusion   High-frequency color Doppler ultrasound has high diagnostic efficacy, with clear imaging features, which can improve the true positive detection rate of thyroid cancer.