甲状腺癌钙化结节的超声研究

目的探讨超声对甲状腺癌的诊断价值.方法对304例术前超声检查并经手术病理证实的甲状腺癌患者的临床资料进行回顾性分析,对其中超声检出钙化结节的123例超声图像进行综合分析并与非癌钙化结节对比.结果123例中术前超声检出135侧甲状腺癌钙化结节,超声与病理诊断符合60侧(44.4%),超声提示为甲状腺实质性肿块45侧(33.3%),漏、误诊30侧(22.2%).甲状腺恶性病变的超声图像以低回声、实质不均质、包膜不清、边界模糊、形态不规则、周边无声晕、血流丰富的微小钙化灶为主.结论超声检查对发现甲状腺结节和鉴别甲状腺良恶性肿瘤具有重要的临床价值,综合分析甲状腺结节灰阶超声及彩色多普勒征象,可提高甲状腺癌鉴别诊断的准确性.

The value of ultrasonography in the diagnosis of thyroid cancer

Objective To investigate the value of conventional ultrasonography(US)and color Doppler flow imaging(CDFI)in the diagnosis of thyroid cancer.Methods Totally,304 patients with thy- roid cancer confirmed by surgery and pathology were examined conventionally by US and CDFI before the op- eration.The image results of calcific nodules from 123 patients with thyroid cancer were analysed and cam- pared with non-cancer calcific nodules.Results Of 135 cases of calcific nodules of thyroid cancer,60 cases(44.4%)were correctly diagnosed,45 cases(33.3%)were diagnosed to be thyroid gland substan- tive lumps and 30(22.2%)were misdiagnosed by ultrasonography.Malignant calcific nodules were hypoe- chogenic,ill defined,solid,irregular,rich blood flow and absent of halo sign.Conclusions The detection and differential diagnosis of benign and malignant thyroid nodules by uhrasonography is clinically valuable. The combination of conventional US characteristic and vascular pattern on CDFI of thyroid cancer can im- prove the accuracy of diagnosis.