甲状腺乳头状微小癌与非微小癌的超声特征

目的分析甲状腺乳头状微小癌与非微小癌的声像图特征。方法回顾性分析242例经手术病理证实的甲状腺乳头状癌患者的超声声像图特征，将其分为直径≤1cm微小癌和直径〉1cm非微小癌，对比两者在形态、纵横比、边界、回声、声晕、钙化、囊变、血流、颈部淋巴结转移及合并甲状腺疾病等方面的差异。结果242例共287个癌灶，其中39例为多灶性（39／242，16．12％）；微小癌154个，非微小癌133个。超声检出274个病灶，漏诊微小癌13个，误诊为结节性甲状腺肿或腺瘤等良性病灶42个。甲状腺乳头状微小癌与非微小癌的边界、纵横比、囊变、血流及颈部淋巴结转移率差异有统计学意义（P均〈0．05），而在形态、钙化、声晕及合并甲状腺疾病上差异无统计学意义（P均〉0．05）。结论超声在甲状腺乳头状癌的诊断中具有重要价值；甲状腺乳头状微小癌与非微小癌的超声表现具有差异。

Ultrasonic features of papillary thyroid microcarcinoma and non-microcarcinoma

Objective To analyze ultrasonic features of papillary thyroid microcarcinoma and non-microcarcinoma. Meth- ods Ultrasonic features of 242 patients with papillary thyroid carcinoma confirmed by pathology were retrospectively ana- lyzed, including microcarcinoma （≤1 cm in diameter） and non-microcarcinoma （〉l cm in diameter）. The shape, ratio of longitudinal/breadth, boundary, echo, periphera halo ring, calcification, cystic changes, blood supply, lymph node metas- tasis and accompanying other thyroid diseases were compared between microcarcinoma and non-microcarcinoma. Results There were 287 lesions in 242 patients, including 154 microcareinomas and 133 non-microearcinomas. The mulifocality rate was 16.12% （39/242）. Ultrasound detected 274 lesions, 13 mierocarcinomas were missed diagnosed, 42 carcinomas were misdiagnosed as benign lesions. There were statistical differences in boundary, ratio of longitudinal/breadth, cystic chan- ges, blood supply and lymph node metastasis between microcarcinomas and non-microcarcinomas （all P〈0. 05）, no statis- tical differences of shape, calcification, periphera halo ring and accompanying other thyroid diseases were found （all P〉0. 05）. Conclusion Ultrasound plays an important role in diagnosis of papillary thyroid carcinoma. Papillary thyroid micro- carcinomas and non-microcarcinomas have different ultrasonic performances.