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目的研究e-Flow超声成像技术在良恶性肿瘤鉴别诊断中的应用价值。方法随机选取60例甲状腺肿瘤患者,其中,术后确诊为甲状腺腺瘤31例,甲状腺癌29例,术前应用e-Flow超声成像技术检测肿瘤内部及转移淋巴结的血流情况,术后应用免疫组织化学技术分别以CD34、CD105标记肿瘤及淋巴结的微血管并统计其密度(MVD),分析血管组织形态,并研究二者与肿瘤类型及淋巴结性质的相关性。结果甲状腺良恶性肿瘤间血流分级差异有统计学意义(P<0.01);恶性甲状腺肿瘤多伴有淋巴结转移,转移淋巴结内血管丰富,以Ⅱ、Ⅲ级为主;非转移性淋巴结内血流信号少,以0、I级为主。甲状腺癌及转移性淋巴结中MVD值高于甲状腺瘤及非转移性淋巴结(P<0.01);甲状腺肿瘤及颈部淋巴结的血流分级与CD34、CD105标记的甲状腺肿瘤血管形态间存在相关性,低血流分级(0、Ⅰ级)与点状、线状血管对应,而高血流分级(Ⅱ、Ⅲ级)与带状、网状血管对应。结论甲状腺肿瘤及颈部淋巴结的血管病理学特征和血流信号分级在良恶性间存在明显差别,e-Flow成像技术在临床鉴别诊断中具有重要价值。
Objective To study the value of e-Flow ultrasonography in the differential diagnosis of benign and malignant tumors. Methods Sixty patients with thyroid tumors were randomly selected. Among them, 31 cases of thyroid adenoma and 29 cases of thyroid carcinoma were diagnosed postoperatively. The echocardiography was used to detect the blood flow in the tumor and metastatic lymph nodes before operation, Histochemical techniques were used to mark the tumor and lymph node microvessels with CD34 and CD105 respectively, and the density (MVD) was calculated. The morphology of the blood vessels was analyzed, and their correlations with tumor types and lymph nodes were also studied. Results There was significant difference in the grade of blood flow between benign and malignant thyroid tumors (P <0.01). Malignant thyroid tumors were mostly accompanied by lymph node metastasis, and the vessels in the metastatic lymph nodes were rich in blood vessels, mainly in grade Ⅱ and Ⅲ. The blood flow in non-metastatic lymph nodes Less signal to 0, I-based. The MVD in thyroid cancer and metastatic lymph nodes was higher than that in thyroid tumors and non-metastatic lymph nodes (P <0.01). There was a correlation between the blood flow classification of thyroid tumors and cervical lymph nodes and the morphological changes of CD34 and CD105-labeled thyroid neoplasms Blood flow classification (0, Ⅰ grade) and point-like, linear vascular corresponding, and high blood flow classification (Ⅱ, Ⅲ grade) and the ribbon, mesh vascular corresponding. Conclusions The pathological features of thyroid tumor and cervical lymph nodes are different from those of blood flow signal grade in benign and malignant tumors. The e-Flow imaging technique is of great value in the differential diagnosis of thyroid tumors and cervical lymph nodes.