Value Of Color Doppler Ultrasound And Microvascular Density In Diagnosing Thyroid Solid Nodule Lesions

IntroductionColor doppler ultrasound is one of the most important examinations of the thyroidand the other neck diseases at the present time, but there are still some disputes in theaspect of diagnosis on benign and malignnant lesions.Recently, the development of mi-crovascular density provide a new direction for the diagnoses of thyroid solid nodulelesions.The paper want to evaluate the diagnose of color doppler ultrasound, mirovas-cular density on the disease of thyroid solid nodule through 115 lesions.The diagnosiswere compared with pathology diagnosis.Materials and methods1. Objectives98 cases of inpatients because of thyroid solid nodule lesions were selected. Thereare 27 cases of male patients and 71 cases of female patients, the average age of themis 45 and the total number of lesions is 115.2.MethodsUltrasonographyAll the US were performed using a linear probe with 7-12MHz (Aplio-80,made byToshiba company,Japan).The two-dimension characters were recorded in detail,recordedtotal scores of every lesion.Each lesion was checked with color doppler ultrasound and graded according tothe degree of blood affluence.Doppler blood flow signal of each lesion was inspected and the Vmax,Vmin,Vm,RI,PI,AC,AT were recorded.Pathology inspectionSurgical biopsy sample was handled by the pointed pathology physicians includingaterial selecting,fixing,embeding,slicing,dying and photic microscope checking.Micro-vascular density counting refer to the method of Weider MVD.We scan the whole pla-stic to find the area with high density blood vessel, hot plot,then the number of bloodvessels was counted,the average of the 5 hot plots acted as number of MVD.Ultrasonic image,pathology diagnosing and Microvascular density counting allall were adopted with blind-methed.3. AnalysisAll the data were adopted means±standard deviation including different total scoreand Vmax,Vmin,Vm,RI,PI,AC,AT.Taking the sensitivity as vertical coordinate and 1-specifitivity as abscissa to depi-ct ROC Curves, if the curve is closed to the top left corner,the sensitivity and specifiti-vity are high, the spot is the best critical point.If the data obey normal distribution, t test was adopted.Wilcoxon test was applica-pplicated in the compare of two groups and Kruskal-Wall test was applicated in the co-mpare of multigroups. The results had statistics meaning if P＜0.05.ResultsClinic data and pathology results1. Thyroid solid nodule lesions usually happen in 40-60 female and the malignantones usually happen in 40-49 female in this group.2. Among 115 lesions, 31 cases are malignant and 84 cases are benign lesions.Ultrasound characters of Thyroid solid nodule lesions1. Two-dimension charactersThe score of the two-dimension characters of thyroid solid nodule lesions has sig-nificant difference(P＜0.001) in shape,boundary,haloecho,microcalcification and diffe-rence(P＜0.05) in backwardecho and no difference in internalecho; The average total score of benign and malignant lesions has significant difference((P＜0.001).According ROC curve,the critical point of the score of the two-dimensioncharacters is 10 scores.2. The degree of blood flowThe degree of blood flow of benign and malignant lesions has significantdifference.The malignant lesions have less blood flow than benign lesions.3. The index of benign and malignant lesionsThe internal RI ang PI of benign and malignant lesions has difference and theother index has no difference.According to ROC curve, the critical point of of RI andPI is 0.6 and 0.8 respectively.4. The microvascular density of benign and malignant lesionsThe microvascular density of benign and malignant lesions have significantdifference.The malignant lesions have more microvascular density than the benignlesions.5. The relationship beteen the microvascular density of benign andmalignant lesionsThey have positive correlation,but no difference statistically.Conclusion1.Color doppler ultrasound will show the characters of thyroid solid nodulelesions.The characters of malignant lesions include illdefined irregular shape,posteriorattenuation,micrcalcif-ication and the total scare is more than 10 scores.2.Color flow imaging can display the conditions of blood supplies, whenvascularity is unorderly and circuity and the index indicate PI＞0.8, RI＞0.6,thepossibility of malignant should be pay attention to.3.The value of RI and PI of thyroid solid nodule lesions have positive correlationwith microvascular density, the value of RI and PI and microvascular density can reflect the angiogenesis of thyroid solid nodule from different aspect and they havecoherence.