甲状腺滤泡状癌声像图分析  

Analysis of ultrasonographic imaging in thyroid follicular carcinoma

作　　者：邬宏恂[1] 王隽[1] 

机构地区：[1]江苏省原子医学研究所附属江原医院超声室,无锡214063

出　　处：《临床超声医学杂志》2007年第9期535-538,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨甲状腺滤泡状癌的二维及彩色多普勒超声表现,以提高术前诊断的准确性。方法回顾性对照分析40例甲状腺滤泡状癌、40例甲状腺乳头状癌及40例甲状腺滤泡状瘤的二维及彩色多普勒声像图特征,计算肿瘤体积及长、厚径之比(L/S比值),观察血流分布状态。以ROC曲线预测阻力指数(RI)对甲状腺滤泡状癌的诊断价值。结果甲状腺滤泡状癌中37例(92.5%)为实质性,3例(7.5%)为混合性。37例实质肿块中20例(54.1%)为等回声,17例(45.9%)为低回声。15例(37.5%)边界不规整,15例(37.5%)周围显示暗带,6例(15.0%)可见液化,8例(20.0%)内部见微钙化灶。滤泡状癌平均体积(46.7±12.9)ml,长、厚径之比(L/S比值)为(1.64±0.39),与乳头状癌组比较,差异均有统计学意义。以RI>0.70为诊断临界点,超声检查敏感性为77.5%,特异性为62.5%。结论甲状腺滤泡状癌表现为等回声或低回声实质肿块,体积偏大,微钙化灶不多见。肿瘤周边不规则暗带及内部少见液化对其有较高的诊断价值。Objective To discuss the characteristics of 2D - ultrasonography（2D US） and CDFI in thyroid follicular carcinoma（TFC） .Methods The characteristics of 2D US and CDFI in 40 cases with TFC were retrospectively analyzed, 40 cases with thyroid follicular adenoma and 40 cases with thyroid papillary carcinoma were as the control. The tumor volume and the ratio of longitudinal and short axes（L/S） were calculated and nodular vascular patterns were observed. Receiver operating characteristic （ROC） curve was used to determine the cut point of resistance index. Results In TFC, solid nodules were found in 37 cases（92.5 % ） and mixed turnors in 3 cases （7.5%）. In 37 cases with solid nodules, 20 （54. 1%）were iso - echoic and 17 （45.9%）were hypoechoic. Fifteen cases （37.5%） had irregular margins, 15 （37.5%）had halos around the rim, 6 （15.0%）had degeneration and 8 （20.0%）had microcalcifications. The average volume of TFC was 46.7 ± 12.9 ml. IJS was 1.64 ± 0.39.The vascular patterns could not distinguish benign from malignant tumors. When the cut point was 0.70 for resistance index, the sensitivity and the specificity were 77.5 % and 62.5 %, respectively. Conclusion TFC manifestates iso - echoic or hypoechoic solid nodules. Majority of the volumes are large with rare microcalcifications. Irregular halos around the rim and rare internal degeneration are useful for diagnosis.

关 键 词：甲状腺滤泡状癌 超声检查 病理检查 

分 类 号：R736.1[医药卫生—肿瘤]