超声检查甲状腺结节内钙化的临床价值  

Sonographic detection for calcification in thyroid nodule

作　　者：毛明锋[1] 杨顺实[1] 袁静萍[2] 鲁慧[1] 江学庆[3] 

机构地区：[1]武汉市中心医院超声科,430014 [2]武汉市中心医院病理科,430014 [3]武汉市中心医院甲状腺乳腺外科,430014

出　　处：《中华内分泌外科杂志》2013年第4期312-315,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的探讨甲状腺结节内钙化类型对良恶性结节诊断的价值。方法回顾性分析了经手术病理证实的235例甲状腺结节患者的355个结节的术前超声图像。观察内容主要包括钙化的有无、大小及分布等。结果良性结节钙化发生率30．3％（89／294），恶性结节发生率73．7％（45／61），2者差异有统计学意义（χ^2=24．3，P〈0．01）。良性结节和恶性结节的微小钙化发生率分别为3．1％（9／294）和47．5％（29／61），2者差异有统计学意义（χ^2=99．1，P〈0．01）；良性结节和恶性结节粗大钙化发生率分别为27．2％（80／294）和26．2％（16／61），2者差异无统计学意义（χ^2=0．42，P〉0．05）。结论甲状腺结节伴微小钙化是诊断甲状腺癌的一个特异性的指标，结节中的每一种钙化都有恶性的风险，不仅微小钙化，包括实性结节内部分布不规则的粗大钙化，恶性的危险性均明显增加。Objective To investigate the significance of sonographic patterns of thyroid calcification in diagnosis of thyroid nodule. Methods 235 patients with 355 thyroid nodules were retrospectively analyzed. Nodule calcification size, distribution and pattern were observed. Results The incidence of calcification in benign and malignant nodules was 30. 3% （89/294）and 73.7% （45/61） respectively. The difference had statistical significance （χ^2 = 24. 3, P 〈 0.01 ）. The rate of microcalcification in cancer was 47. 5 % （29/61 ） , higher than that in benign one 3. 1% （9/294） （χ^2 =99. 1, P 〈 0. 01 ）. Coarse calcification in benign nodules and malignant lesion was 27. 2% （80/294）and 26. 2% （16/61）respectively. The difference had no statistical significance（χ^2 = 0. 42, P 〉 0. 05 ）. Conclusions Microcalcification of thyroid nodules is a specific index for thyroid carcinoma. Any type of sonographically detected calcification represents risk of malignancy. Not only microcalcification, these cases should raise the suspicion of malignancy in coarse calcification, especially involving a solitary nodule and irregular shape.

关 键 词：超声检查 甲状腺结节 钙化 

分 类 号：R445.1[医药卫生—影像医学与核医学]