摘要
目的探讨甲状腺乳头状癌彩色多普勒超声显像中血流参数与病理微血管密度(microvessel density,MVD)的关系及其对甲状腺乳头状癌术前诊断的临床意义。方法术前应用彩色多普勒超声检测29例甲状腺肿瘤患者的血流参数,记录收缩期最高流速(peak systolic velocity,Vmax)和舒张期末最低流速(end-diastolic velocity,Vmin),并计算阻力指数(resistance index,RI)。术后对所有病例标本应用抗Ⅷ因子相关抗原多克隆抗体进行免疫组织化学染色,测定肿瘤 MVD 值,并进行统计学分析。结果术后病理示甲状腺乳头状癌17例,甲状腺腺瘤12例。甲状腺乳头状癌的超声血流参数中 RI 值明显高于甲状腺腺瘤(t=3.3108,P<0.01),而 Vmax 和 Vmin 在两者之间差异无统计学意义(Z=0.9520,P>0.05;Z=-1.6618,P>0.05)。甲状腺乳头状癌的 MVD 值高于甲状腺腺瘤,两者间差异有统计学意义(t=8.1991,P<0.01)。甲状腺肿瘤的 RI 值与 MVD 值呈正相关(r=0.7924,P<0.01)。结论彩色多普勒超声能较好地显示甲状腺及其肿瘤的血流情况,血流参数RI 在甲状腺乳头状癌中高于甲状腺腺瘤,并与 MVD 密切相关,故术前超声检查中检测 RI 值对诊断甲状腺乳头状癌有一定参考价值。
Objective To determine the relationship between velocimetric parameters by using color Doppler ultrasonography and microvessel density （MVD） in papillary thyroid carcinoma and its clinical significance for preoperative diagnosis of papillary thyroid carcinoma. Methods Twenty-nine thyroid tumors were examined preoperatively by color Doppler ultrasonography. The velocimetric parameters including peak systolic velocity （Vmax）, end-diastolic velocity （Vmin） were evaluated respectively and resistance index （RI） was calculated. Immunohistochemistry was applied by using polyclonal rabbit anti-human Von Willebrand factor in all cases after operation and microvessel density was calculated based on it. Results Of the twenty-nine patients who underwent surgery, seventeen patients were diagnosed in papillary thyroid carcinoma and twelve patients in thyroid adenoma. In velocimetric analysis, the RI was significantly higher in patients with papillary thyroid carcinoma than those with thyroid adenoma（ t = 3.3108, P 〈 0. 01 ）. V max and Vmin were no significance in those two tumors respectively （ Z = 0. 9520, P 〉 0. 05 ; Z = - 1. 6618, P 〉0. 05）. MVD was also significantly increased in patients with papillary thyroid carcinoma（ t = 8. 1991, P 〈0. 01 ）. There was a significant positive association between RI and MVD （ r = 0. 7924, P 〈 0. 01 ）. Conclusions Color Doppler uhrasonography could well display the blood flow of thyroid tissue and its nodules. The velocimetric parameter RI was higher in papillary thyroid carcinoma than in adenoma and was along with its MVD. RI may provide valuable information for diagnosis of papillary thyroid carcinoma preoperatively.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2007年第2期126-129,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
甲状腺肿瘤
超声检查
多普勒
彩色
微血管密度
Thyroid neoplasms
Ultrasonography, Doppler,color
Microvessel density
