高频超声对甲状腺乳头状微小癌的诊断价值

目的分析甲状腺乳头状微小癌（PTMC）的超声声像图特点，以提高PTMC的术前超声检出率。方法回顾性分析经手术病理证实的46例（46个）PTMC病灶的超声二维声像图表现，并以同期51例（51个）直径≤1．0cm的NG结节作为对照组对比分析。结果PTMC与NG结节在形态、边界、纵横比、内部回声、微小钙化、囊性变等方面差异有统计学意义（P〈0．01）。结论高频超声对诊断PTMC及术前评估有重要价值。PTMC具有与NG结节不同的声像图特点，PTMC的灰阶超声特点为形态不规则、低回声、边界模糊、有微小钙化、无囊性变。对NG患者。重点观察≤1cm的低回声结节，以及早发现PTMC，并且常规扫查中央区淋巴结，尤其对高度怀疑多灶性的胛MC患者或者甲状腺外浸润者，更要仔细扫查。

The diagnostic value of high frequency ultrasound PTMC

Objective To analyze the sonographic appearance of papillary microcarcinoma of the thyroid （PTMC）, and to increase the preoperative detection rate of PTMC. Methods The ultrasonographic features of 46 cases （46 nod- ules） of PTMC were analyzed compared with the result of 51 cases （51 nodules ） of nodular goiter （NG）≤1cm in the same period. Results There was statistical difference in shape, boundary, echo intensity, microealcification, cystic degeneration between PTMC and NG （P 〈 0.01 ）. Conclusion High frequency ultrasound in the diagnosis of PTMC and preoperative assessment has important value, PTMC has different sonographic features from NG nodules. PTMC shows form irregular,low-echo, boundary fuzzy ,small calcification, no halo or cystic degeneration on gray-scale ultrasound images. Observing the low level echo nodule which is ≤1cm in diameter will be helpful to detect PTMC early, and scan level Ⅵ lymph nodes routinely, muhifocality and extra-thyroidal invasion should be scaned more carefully.