甲状腺癌278例超声声像图特征分析

目的:研究高频超声显像在甲状腺癌诊断中的应用价值。方法:对经手术及病理证实的278例309个甲状腺癌结节的声像图进行分析,比较不同病理类型及同一病理类型甲状腺癌的声像图特征。结果:278例甲状腺癌患者中单灶型259例,多灶型19例;乳头状癌264例,甲状腺滤泡癌9例,髓样癌4例,未分化癌1例。其中低回声结节241例,囊实混合性结节28例,稍高回声结节9例。264例乳头状癌中微小乳头状癌78例,其中45例结节内部和边缘显示血流信号,33例未见明显血流信号;有51例伴细小钙化,钙化率65.4%。较大乳头状癌186例,其中184例结节内部和边缘显示血流信号,2例未见明显血流信号,差异有统计学意义(P<0.01);有84例伴细小钙化,钙化率45.0%,差异有统计学意义(P<0.01)。结论:掌握各类甲状腺癌的超声声像图特征性表现,可以减少漏诊误诊,为临床采取合理的治疗方案提供有价值的信息。

Ultrasonographic characteristics analysis of 278 cases with thyroid carcinoma

Objective:To evaluate the application value of high-frequency ultrasound imaging in the diagnosis of thyroid carcinoma. Methods:The ultrasonograms data in 309 thyroid cancer nodules(278 cases) confirmed by surgery and pathology were retrospectively analyzed. The sonographic features between different pathological types and the same pathological type of thyroid carcinoma were compared. Results:Among the 278 thyroid carcinoma patients,unifocal in 259 cases and multifocal in 19 cases were found,the papillary carcinoma in 264 cases,follicular thyroid carcinoma in 9 cases,medullary carcinoma in 4 cases and undifferentiated carcinoma in 1 case were identified,the hypoechoic nodules in 241 cases,mixed cystic and solid nodule in 28 cases and slightly high level echo nodule in 9 cases were identified. Two hundred and sixty-four papillary carcinoma patients included 78 cases of small papillary carcinoma and 186 cases of large papillary carcinoma. Among the small papillary carcinoma patients,the blood signal in internal and edge of 45 cases,and no significant blood signal in 33 cases were showed,and the 51 cases with small calcification were found,the calcification rate of which was 65. 4%. Among the large papillary carcinoma patients,the blood signal in internal and edge of 184 cases and no significant blood signal in 2 cases were showed,the difference of which was statistically significant(P<0. 01),and the 84 cases with small calcification were found,the calcification rate of which was 65. 4%,the difference of which was statistically significant(P<0. 01). Conclusions:Knowing the characteristics of ultrasound performance of various types of thyroid carcinoma can reduce its missed diagnosis and misdiagnosis,which can provide the valuable information in taking reasonable clinical treatment.