甲状腺乳头状癌的超声诊断及误诊分析

目的：探讨甲状腺乳头状癌的超声声像图特点及误诊原因。方法回顾性分析37例经手术病理证实为甲状腺乳头状癌病例的声像图特点，包括病灶的边界、内部回声、是否有微钙化、彩色多普勒血流信号情况以及颈部是否探及淋巴结等。结果超声诊断明确提示恶性肿瘤11例（29.8%），占位性改变等高度怀疑恶性13例（35.1%）；误诊为腺瘤或腺瘤囊性变12例（32.4%），亚急性甲状腺炎性改变1例（2.7%）。结论甲状腺乳头状癌具有特征性的超声声像图表现，因此高频超声对于诊断甲状腺乳头状癌很有帮助，但是需要注意不典型甲状腺腺瘤和多发性病灶，警惕良恶性并存。

Ultrasonic manifestations and the misdiagnosis analysis of papillary thy-roid carcinoma

Objective To evaluate the ultrasonic manifestations and pitfalls of papillary thyroid carcinoma （PTC）. Methods Ultrasonographic characteristics of 37 cases with papillary thyroid carcinoma confirmed by surgical patholoy were retrospectively analyzed.Boundary,shape,echo intensity,microcalcification,CDFI of mass and neck lymphadenopathy were recorded. Results 11 PTC（29.8%） were clearly diagnosed;13 cases（35.1%） were highly suspected of malignancy;12 cases were（32.4%） misdagnosed as thyroid adenoma and 1 case（2.7%） was misdiagnosed as subacute thyroiditis. Conclusion PTC has characteristic ultrasound manifestations,high frequency ultrasound is of value for the ealy detection of PTC,nevertheless,much attention should be payed to untypical thyroid adenomas and multiple lesions,because benigh and malignant leisions can coexist.