Application value of two-dimensional ultrasound combined with carotid Doppler ultrasound in differentiating the nature of thyroid nodules
10.3760/cma.j.cn341190-20241113-01497
- VernacularTitle:二维超声联合CDU对甲状腺结节性质鉴别诊断的价值研究
- Author:
Yingyi WANG
1
;
Jiangying WANG
1
;
Shuli YANG
1
Author Information
1. 绍兴市第七人民医院特检科，绍兴 312000
- Publication Type:Journal Article
- Keywords:
Thyroid nodule;
Ultrasonography;
Ultrasonography, doppler, color;
Hemodynamics;
Pathology;
Diagnosis, differential
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(6):893-898
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of two-dimensional ultrasound (2DUS) combined with carotid Doppler ultrasound (CDU) in differentiating the nature of thyroid nodules.Methods:This study used a prospective research design. A total of 126 patients with thyroid nodules treated at Shaoxing 7 th People's Hospital from January to September 2023 were included in this study. All patients underwent both 2DUS and CDU examinations. The diagnostic value of 2DUS and CDU was evaluated, both individually and in combination, for differentiating between malignant and benign nodules. The detection rates of specific 2DUS signs (such as indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance) were compared between malignant and benign nodules. The blood flow patterns (types I, II, and III) and parameters (end-diastolic flow velocity, peak systolic flow velocity, and resistance index) obtained from CDU were compared between malignant and benign nodules. Using surgical pathology results as the gold standard, the diagnostic value of 2DUS and CDU was compared, both individually and in combination. Results:Surgical pathology results showed that there were 78 cases of malignant nodules [61.90% (78/126)] and 48 cases of benign nodules [38.10% (48/126)]. The detection rate of malignant nodules using CDU was slightly, but not significantly, higher than that of 2DUS ( P > 0.05). However, the detection rate of malignant nodules using the combined examinations [60.32% (76/126)] was significantly higher than that of either 2DUS [41.27% (52/126)] or CDU alone [47.62% (60/126)] ( χ2 = 9.15, P = 0.002; χ2 = 4.09, P = 0.043). The detection rates of indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance in malignant nodules were significantly higher than those in benign nodules (all P < 0.001). The proportions of type II and type III blood flow in malignant nodules were significantly higher than those in benign nodules (both P < 0.05). End-diastolic flow velocities in malignant nodules were significantly lower than those in benign nodules ( P < 0.05). Peak systolic flow velocity and resistance index in malignant nodules were significantly greater than those in benign nodules (both P < 0.05). Using surgical pathology results as the standard, the accuracy, sensitivity, and specificity of the combined examinations in differentiating the nature of thyroid nodules were 96.83% (122/126), 96.15% (75/78), and 97.92% (47/48), respectively. The diagnostic accuracy and sensitivity of the combined examinations were significantly higher than those of 2DUS and CDU individually (all P < 0.05). Conclusions:The combination of 2DUS and CDU is highly valuable for the differential diagnosis of thyroid nodules. Integrating findings from 2DUS and CDU blood flow patterns and parameters offers important guidance for clinical diagnosis.
