超声对隐匿性甲状腺癌的早期诊断  

Early diagnosis of occult carcinoma of the thyroid by ultrasonography

作　　者：原韶玲[1] 杨立[1] 关莉丽[1] 易涛[1] 王宇翔[1] 郭荣荣[1] 赵培鹏[1] 

机构地区：[1]030013,太原,山西省肿瘤医院超声室

出　　处：《中华医学超声杂志（电子版）》2005年第5期275-277,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声对隐匿性甲状腺癌(OCT)的早期诊断价值.方法应用彩色多普勒超声仪对30例OCT患者的甲状腺结节形态、大小、回声、边界、内部砂粒、血流分布等声像图表现及其内部血流状况进行观察,并与手术病理结果对照;计算结节短径与长径之比(S/L),扫查颈部及气管食管沟区淋巴结.根据结节及局部淋巴结的超声表现,判断结节的性质,并将结节分为良性组;不能确定性质组;恶性组.结果术前超声检出甲状腺结节28例(28/30,44个结节),21例为单发实性结节,9例为多发结节.所有OCT结节直径均＜1.0 cm,44个结节均＜1.5 cm,其S/L＞0.5,结节内部有不同程度血流信号,9例(9/28)内部有砂粒样强回声,11例(11/28)伴颈部或气管食管沟区淋巴结显示.超声提示良性3例,不确定性质13例,恶性12例,漏诊2例.超声对OCT的正确诊断不确定性质组+恶性组为25例(25/30).结论超声检查可提高OCT的早期检出率和诊断率.Objective To summarize the ultrasonographic manifestations and internal blood flowing imaging of occult carcinoma of the thyroid （ OCT）, and to evaluate the role of ultrasound for early diagnosis of OCT. Methods Using ultrasonography, the size, morphology, location, echo, margin, internal micro- calcifications and internal blood flowing of thyroid nodules were examined and compared with the surgical and pathological findings in 30 patients with OCT; and the ratio of the minimum width to the maximum length of the nodules （S/L）was calculated. The lymph nodes in the neck or in tracheoesophageal sulcus were scanned. According to ultrasonographic features of the nodules and adjacent lymph nodes in the thyroid, the nodules were classified into 3 categories ： benign, undetermined and malignant. Results Twenty-eight cases （28/30, 44 nodules） of OCT were revealed by ultrasound examination. On uhrasonography, 21 cases had solitary, solid nodules ; 9 cases had more than one nodules. All nodules of OCT were solitary, solid and less than 1.0 cm in diameter. The diameter of 44 nodules was less than 1.5cm, and their S/L ratio was more than 0.5. The OCT nodules manifested signals of blood flowing to various degrees ; micro-calcifications were detected in 9 cases （9/28）of OCT; and lymph nodes were found in the neck or tracheoesophageal sulcus in 11 cases （11/28）of OCT. Accurate diagnosis by ultrasound was in 12 cases （12/30）; and 25 cases （25/30） in malignant and undetermined groups were accurately diagnosed by ultrasound. Conclusions Ultrasound can improve the rates of early detection and diagnosis of OCT.

关 键 词：甲状腺结节 甲状腺肿瘤 超声检查 彩色多普勒超声仪 隐匿性甲状腺癌 早期诊断价值 局部淋巴结 气管食管沟 手术病理结果 血流分布 

分 类 号：R459.5[医药卫生—治疗学] R736.1[医药卫生—临床医学]