甲状腺微小癌的超声图像特征

目的：探讨甲状腺微小癌（thyroid microcarcinoma,TMC）的超声图像特点。方法：回顾分析经手术和病理证实的101例TMC患者共105个结节的超声声像图,观察结节的数目、位置、形态、大小、边界、内部回声、钙化和血流分布,测量收缩期峰值流速（peak systolic velocity,PSV）和阻力指数（resistance index,RI）。结果：超声显示,66个结节（62.9%）为低回声,45个结节（42.9%）伴微钙化,75个结节（71.4%）纵横比（anteroposterior and transverse diameter ratio,A/T）≥1,54个结节（51.4%）形态不规则,57个结节（54.3%）边界不清,21个结节（20.0%）彩色多普勒超声（color Doppler flow imaging,CDFI）检出血流信号;PSV8.6~43.4 cm/s;RI 0.56~0.95,均值0.71。21例TMC患者（20.8%）有淋巴结转移,60例合并结节性甲状腺肿。结论：低回声的实性小结节、A/T≥1、瘤内微钙化、无囊性变是TMC的超声特征,其常有结节性甲状腺肿的背景。

Ultrasound Characteristics of Thyroid Microcarcinoma

Objective：To investigate the ultrasound characteristics of thyroid microcarcinoma（TMC）.Methods：The ultrasound image findings of 101 patients with TMC（a total of 105 nodules）confirmed by surgery and pathologic results were analyzed retrospectively.Nodule number,position,shape,size,borders,internal echo,calcification and blood flow were observed;peak systolic velocity（PSV）and resistance index（RI）were detected.Results：Sixty-six（62.9%）nodules showed hypo-echo.Forty-five（42.9%）nodules showed microcalcification.Seventy-five（71.4 %）nodules were with anteroposterior and transverse diameter ratio（A/T）≥1.Fifty-four（51.4%）nodules showed irregular shape.Fifty-seven（54.3%）nodules showed ill-defined boundary.Blood flow was detected in 21 nodules（20.0%）by color Doppler flow imaging（CDFI）.PSV was from8.6 to 43.4 cm/s,and RI was from0.56 to 0.95（mean,0.71）.Lymph node metastasis was found in21 patients（20.8%）.Sixty patients with TMC were combined with nodular goiter.Conclusions：Hypo-echo nodules,A/T≥1,microcalcification,without cystic changes are ultrasound characteristics of TMC,which often has a background of nodular goiter.