高频超声在甲状腺癌诊断和鉴别诊断中的应用——附380例病例分析

目的探讨甲状腺癌的声像图表现规律及高频超声在甲状腺癌诊断和鉴别诊断中的应用价值.方法对我院2001年1月-2005年5月经手术病理诊断为甲状腺癌且资料完整的380例患者的声像图资料作回顾性分析.结果本组380例甲状腺癌以乳头状癌占多数,超声诊断正确率为75.26%,其声像图特点为:(1)肿瘤形态呈球形、类圆形或不规则形;(2)肿瘤边缘不光整呈毛刺状、蟹足样,声晕出现率低;(3)肿瘤以实质性低回声为主,72.90%;(4)肿瘤内部常伴钙化,发生率56.78%;(5)癌结节血供丰富.部分癌结节呈多发性及与良性结节并存,给诊断带来困难,尤其是直径在0.5cm以下的癌结节容易漏诊.结论高频超声在甲状腺癌的诊断和鉴别诊断中具有较高的临床应用价值.

Clinical application of high-resolution ultrasound in diagnosis and differential diagnosis of thyroid carcinoma

Objective To find the rule of thyroid carcinoma with high-resolution ultrasound, and to validate the accuracy in diagnosis of thyroid carcinoma retrospectively. Methods A total of 380 patients with final confirmation by histopathology after operation with complete data from Jan 2001-May 2005 in Tumor Hospital, affiliated to Fudan University. Results Most of these cases had papillary adenocarcinomas, and the ultrasound diagnostic accuracy was 75.26%. The characteristics on high-resolution sonography were: 1. The shapes of tumors were round and irregular; 2. The edge of tumors were irregular, and haloes rare; 3. 72.90% of tumors were substantially hypoechogenic; 4. 56.78% of tumors were often calcified; 5. Tumors were vascular. Conclusions The high-resolution sonography is worthy for diagnosis and differential diagnosis of thyroid diseases.