合并肿瘤结节的弥漫性硬化型甲状腺乳头状癌的影像学特征分析

目的:分析合并肿瘤结节的弥漫性硬化型甲状腺乳头状癌的影像学特征.方法:分析6例弥漫性硬化型甲状腺乳头状癌(DSVPTC)的高频超声表现、弹性成像技术、X线摄影表现及CT表现,并与经典型甲状腺乳头状癌(CPTC)进行对比.结果:6例(100%)DSVPTC患者甲状腺实质均有砂砾样钙化,3例(75%)累及甲状腺双侧叶,3例(75%)合并淋巴结转移或肺转移;结节血流信号Ⅰ-Ⅱ级,弹性分级Ⅲ级;CT显可显示肿瘤结节内的营养不良性钙化,但不能显示微钙化,X线摄影能更好的显示微钙化.结论:合并肿瘤结节的弥漫性硬化型甲状腺乳头状癌兼具CPTC与DSVPTC的超声特征,超声能为临床提供重要的诊断依据,超声联合X线摄影有重要的诊断价值.

Diffuse sclerosing variant of papillary carcinoma of the thyroid with tumor nodule:Fea-tures on ultrasonography

Objective:To evaluate the imaging features of diffuse sclerosing variant of papillary carcinoma of the thyroid (DSVPTC)with tumor nodule. Methods:The high frequency ultrasound features,the ultrasonic elastography, specimen radiographs and CT features of 6 DSVPTC were analyzed,and compared with the CPTC. Results:6 cases (100%)of DSVPTC patients with microcalcifications,3 cases(75%)were bilateral. 3 cases(75%)were with lymph node metastasis or lung metastasis. Nodule blood flow signal was grade I - II. Ultrasonic elastosonography was grade III. CT can show the nutrition of the tumor nodules,but can not show the microcalcification. X - ray photography can better display microcalcification. The pathological features of DSVPTC with tumor nodules were diffuse fibrosis,a large number of squamous metaplasia,lymphocyte infiltration,and a large number of sand bodies. Conclusion:DSVPTC with tumor nodules has the characteristics of both CPTC and DSVPTC.Ultrasonography is a very usefull tool for the diag-nose of DSVPTC and the combination of ultrasonography and specimen radiographs has important value of diagnosis.