高频超声对甲状腺髓样癌的诊断价值

目的探讨高频超声在甲状腺髓样癌的诊断价值。方法对我院2005年9月～2010年9月经手术病理证实的甲状腺髓样癌（25个结节）的声像图特点进行、研究。选取同期甲状腺乳头状癌126个结节作为对照。并将每个结节评估为可疑恶性、良恶性不确定或可能良性。甲状腺髓样癌和乳头状癌之间的比较使用卡方检验。结果二维声像图上提示两者的位置、内部回声、边缘、回声强度、钙化形式、颈部淋巴结差异无统计学意义（P〉0．05）。甲状腺髓样癌的超声特征包括位于甲状腺中上极（68％），实性结节（92％），形状呈圆形或卵圆形（56％），边缘模糊或可见毛刺（80％），更低回声结节（52％）和钙化（52％）。25个甲状腺髓样癌的结节中20个（80％）被评估为可疑恶性结节。甲状腺髓样癌的平均长径为20±12．7mm，甲状腺乳头状癌平均长径为12±5．5mm，差异有统计学意义（P〈0．05）。甲状腺髓样癌中圆形或卵圆形结节的比例大于甲状腺乳头状癌（P〈0．05）。结论甲状腺髓样癌除甲状腺恶性结节的一般特点外，还有相对特异性的声像图特征，超声检查可为临床早期诊断和手术治疗提供有价值的参考依据。

Significance of high frequency ultrasonography in detecting medullary thyroid carcinoma

Objective To evaluate the significance of uhrasonography in diagnosis of medullary thyroid carcinoma. Methods The ultrasonographic features were analyzed in 25 nodules of medullary thyroid carcinoma proved by pathologic examination after operation during September 2005 to September 2010, and data of uhrasonography in 126 nodules of papillary thyroid carcinoma in the same period were also analyzed. Each nodule was evaluated as suspicious malignant, indeterminate or probably benign. The findings of medullary and papillary carcinomas were compared using the chi-squared test. Results The position, internal content, margin, echogenicity, calcification and cervical lymph node on ultrasound imaging were not different significantly （P= 0.564, P=0.749, P=0.126, P=0.268, P=0.190, P=0.786）. The US findings for MTCs were in middle and upper pole of thyroid （68%）, solid internal content （91%）, ovoid or round shape （56%）, spieulated or ill-defined margin （ 80% ）, marked hypoechogenicity （52%） and calcifications （52%）. Among the 25 nodules of MTC, 20 nodules （80%） were classified as suspicious malignant nodules. The mean size （longest diameter） of MTC lesions was 20 ± 12.7 mm and the mean size （longest diameter） of PTC lesions was 12 ±5.5 mm. This difference was statistically significant （P〈0.05）. Ovoid or round shape was more prevalent in MTC nodules than in PTC nodules （P〈 0.05）. Conclusion The sonographic findings of MTC were similar to the other thyroid malignancy and had their own characteristics. Ultrasonography can provide valuable information for early diagnosis and surgical treatment of these patients.