甲状腺微小乳头状癌的超声诊断与分析

目的：探讨甲状腺微小乳头状癌的超声诊断价值。方法：回顾性分析经手术、病理组织学检查确诊的直径均≤1.0cm的74个甲状腺微小乳头状癌和135个甲状腺良性结节的超声表现,对2组结节的各项超声表现的差异进行统计学分析,并分别计算其诊断的敏感性、特异性及准确性。结果：边缘毛糙（敏感性62.2%、特异性91.9%、准确性81.3%）、形态不规则（敏感性60.8%、特异性93.3%、准确性81.8%）、纵横比≥1（敏感性66.2%、特异性93.3%、准确性83.7%）、结节内部有微小钙化（敏感性62.2%、特异性97.8%、准确性85.2%）、伴颈部淋巴结肿大（敏感性18.9%、特异性95.6%、准确性68.4%）以及结节内部血流信号丰富（敏感性27.0%、特异性94.8%、准确性70.8%）在恶性组患者中的检出率较高（P〈0.05）。结论：边缘毛糙、形态不规则、纵横比≥1及结节内部有微小钙化灶是诊断甲状腺微小乳头状癌的重要指标,伴颈部淋巴结肿大及结节内部血流信号丰富的敏感性较低,可作为鉴别诊断的参考指标。

Study of Ultrasound Diagnosis in the Papillary Thyroid Microcarcinoma

Objective：To investigate the value of Ultrasonography in the diagnosis of papillary thyroid microcarcinoma（PTMC）.Methods：The ultrasonic characteristics of 74 PTMC and 135 thyroid benign nodules were retrospectively reviewed.All masses were less than 1.0 centimeters in their greatest diameter and confirmed by operation and pathology.The different ultrasonic characteristics were analyzed statistically.Sensitivity,specificity and accuracy were obtained.Results：Statistically significant（P0.05）findings of PTMC were speculated margin（sensitivity,62.2% ;specificity,91.9% ;accuracy,81.3%）,irregular shape（sensitivity,60.8% ;specificity,93.3% ;accuracy,81.8%）,A/T（anteroposterior/transverse diameter ratio）≥1（sensitivity,66.2% ;specificity,93.3% ;accuracy,83.7%）,microcalcifications（sensitivity,62.2% ;specificity,97.8% ;accuracy,85.2%）,enlarged lymphnodes on the neck（sensitivity,18.9% ;specificity,95.6% ;accuracy,68.4%）and abundant blood flow signals inside the lesions（sensitivity,27.0% ;specificity,94.8% ;accuracy,70.8%）.Conclusion：Speculated margin,irregular shape,A/T≥1,microcalcifications were important indicators in the discrimination of PTMC from benign nodules.For enlarged lymph nodes on the neck and the abundant blood flow signals inside the lesions,their sensitivities were low,which can be used as reference.