Abstract: Background　There have been several studies on the differential diagnosis of benign and malignant thyroid nodules with coarse calcification by gray-scale information and elasticity imaging，but few literatures have reported the diagnostic value of blood flow information.Objective　To explore the value of blood flow information in differential diagnosis of benign and malignant thyroid nodules with coarse calcification.Methods　A retrospective analysis of 103 patients with thyroid nodules（a total of 108 solid nodules with coarse calcification） from the First Affiliated Hospital of Harbin Medical University between October 2017 to December 2018 was performed.The internal blood flow grade of benign and malignant thyroid nodules and the blood flow distribution types in the internal nodules and peripheral glands were compared.Results　Among the 108 nodules，there were 59 malignant nodules and 49 benign nodules.The incidence of grade 0，grade 2，and grade 3 blood flow in benign and malignant thyroid nodules were not statistically significant（χ2=0.96，0.03，0.81，P>0.05），while the incidence of grade 1 blood flow in malignant thyroid nodules was higher than that in benign thyroid nodules（χ2=6.26，P<0.05）.There was significant difference in the blood flow distribution types in the internal nodules and peripheral glands （P<0.05）.The blood flow distribution type Ⅲ and Ⅳ were more frequently detected in malignant nodules，and typeⅠ，Ⅱ and Ⅳ were more frequently detected in benign nodules（P<0.05）.Conclusion　Blood flow grade 1 and distribution type Ⅰ，Ⅱ and Ⅳ are more common in benign nodules；type Ⅲ and Ⅳ are more common in malignant nodules.Observing the blood flow distribution types in the internal nodules and peripheral glands is helpful for the diagnosis of the benign and malignant thyroid nodules with coarse calcification.

Key words: Thyroid nodule；Coarse calcification；Regional blood flow；Ultrasonography, doppler, color

摘要： 背景　灰阶信息及弹性成像等技术对伴有粗大钙化甲状腺结节的良恶性鉴别诊断已有一定研究，但鲜有文献报道血流信息对其的诊断价值。目的　初步探讨血流信息对于鉴别诊断伴粗大钙化甲状腺结节良恶性的价值。方法　回顾性分析2017年10月—2018年12月于哈尔滨医科大学附属第一医院就诊的甲状腺结节患者103例，共计108个结节，均为伴有粗大钙化的实性结节。对比分析良性和恶性甲状腺结节内部血流分级及结节内部及周围腺体血流分布分型。结果　108个甲状腺结节中，良性49个，恶性59个。良、恶性甲状腺结节0级、2级、3级血流发生率比较，差异均无统计学意义（χ2=0.96、0.03、0.81，P>0.05）；恶性甲状腺结节1级血流发生率高于良性甲状腺结节（χ2=6.26，P<0.05）。良、恶性甲状腺结节内部及周围腺体血流分布分型比较，差异有统计学意义（P<0.05）；其中恶性甲状腺结节内部及周围腺体血流分布分型Ⅰ、Ⅱ、Ⅳ型发生率低于良性甲状腺结节，Ⅲ、Ⅳ型发生率高于良性甲状腺结节，差异有统计学意义（P<0.05）。结论　血流分级1级多见于良性结节；血流分布分型Ⅰ、Ⅱ、Ⅳ型多见于良性结节；Ⅲ、Ⅳ型多见于恶性结节，观察伴粗大钙化甲状腺结节内部及周围腺体血流分布情况有助于良恶性鉴别诊断。

关键词: 甲状腺结节；粗大钙化；局部血流；超声检查, 多普勒, 彩色