甲状腺髓样癌的超声特点

目的分析研究甲状腺髓样癌（MTC）的超声声像图特点。 方法回顾性总结分析49例手术病理证实的MTC的临床及声像图特点（61个病灶）。以北京协和医院64例手术病理证实的甲状腺乳头状癌（PTC）作为对照组（79个病灶），比较MTC与PTC在病灶大小、形态、回声、钙化、内部血流及颈部淋巴结等方面的差异性。 结果与PTC相似，MTC多表现为低回声（51/61，83.6%）、边界不清（39/61，63.9%）,可见微小钙化（33/61，54.1%）及颈部淋巴结异常（22/49，44.9%）。不同之处在于：MTC病灶较大，中位数（M）=2.2 cm，四分位数间距（Q）=1.7 cm，PTC病灶大小为M=0.8 cm，Q=0.7 cm，两者相比差异有统计意义（P<0.001）；MTC多椭圆，纵横比>1的病灶有4个（4/61，6.6%），PTC纵横比>1的病灶有45个（45/79，57.0%），差异有统计意义（P<0.001）；MTC混合回声病灶相对较多10个（10/61，16.4%），PTC混合回声病灶2个（2/79，2.5%），差异有统计意义（P=0.003）；MTC内部血流信号丰富病灶56个（56/61，91.8%），PTC内部血流信号丰富病灶31个（31/79，39.2%），差异有统计意义（P<0.001）。 结论MTC与PTC超声表现相似，但存在差异性，在诊断过程中应予以重视。

Sonographic features of medullary thyroid carcinoma

ObjectiveTo investigate sonographic features of medullary thyroid carcinoma (MTC). MethodsClinical and sonographic features of MTC in 49 pathologically confirmed patients were retrospectively analyzed, 64 pathologically proven papillary thyroid carcinoma (PTC) patients were settled as control group. Sonographic features such as lesion size, shape, echogenicity, calcification, intranodular vascularity and neck lymphadenopathy were compared between MTC and PTC groups. ResultsBoth MTC and PTC lesions were often presented as hypoechoic (51/61, 83.6%) with unclear margin (39/61, 63.9%), microcalicifications (33/61, 54.1%) and neck lymphadenopathy (22/49, 44.9%) were noticed in both two groups. Compared with PTC (M=2.20 cm, Q=1.70 cm), the mean size of MTC (M=0.80, Q=0.70 cm) was larger (P<0.001); MTC group presented less ?taller than wide? feature [4/61 (6.6%) vs 45/79 (57.0%), P<0.001]; Complex echogenicity in MTC group were more commonly seen [10/61 (16.4%) vs 2/79 (2.5%), P = 0.003]; More MTC lesions presented increased intranodular vascularity [56/61 (91.8%) vs 31/79 (39.2%), P<0.001]. ConclusionSonographic features of MTC and PTC group were similar, however, the statistical difference between two groups were noticed and should be considered in the process of thyroid nodule diagnosis.