超声影像在原发性甲状腺鳞状细胞癌中的临床诊断价值  

The Clinical Value of Ultrasonic Characters in the Diagnosis of Primary Squamous Cell Carcinoma of the Thyroid

作　　者：刘颖[1] 郭晓波[1] 胡耀红[1] 叶晓铿 池淑宏[1] 

机构地区：[1]南京军区福州总医院476临床部超声科,福建福州350002

出　　处：《现代生物医学进展》2014年第30期5884-5887,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨超声影像在原发性甲状腺鳞状细胞癌(PSCCT)中的临床诊断价值。方法:收集住院经组织病理学确诊的PSCCT患者6例,回顾性分析其临床一般资料及超声影像学资料。结果:6例PSCCT患者年龄(49-77)岁,平均年龄64岁,临床上均表现为甲状腺肿大,4例伴呼吸困难,3例伴吞咽困难,3例伴声音嘶哑。6例患者均死亡,术后生存4-13个月,平均术后生存期8.5个月。超声影像学特点:16例PSCCT病灶大小较大(最大直径3.0-5.1 cm),结节为形态不规则,且边界不清晰的实性混合性回声肿块,内部可见片状极低回声区。2例患者的肿块内部存在少许微量钙化,另外4例则无明显钙化表现;2结节突破甲状腺被膜3例,且与甲状腺周围组织分界不清晰;34例结节内部血流信号表现为少量,呈点线状分布,2例结节内部血流信号表现为中量;45例肿块可测得高阻力频谱(RI0.72-0.88);5 3例患者伴有颈部异常淋巴结。结论:PSCCT具有一定超声影像特点,与临床表现相结合有助于该病的鉴别诊断。Objective： To explore the clinical value of ultrasonic characters in the diagnosis of primary squamous cell carcinoma of the thyroid （PSCCT）. Methods： The clinical data and ultrasonic characters of 6 patients with PSCCT confirmed by pathology post surgery were retrospectively reviewed. Results： The age range of the 6 patients with PSCCT were from 49 to 77, and the average age was 64.All of 6 patients were presented with a enlargement of the thyroid gland, 4 patients had difficulty in breathing, 3 patients had difficulty in swallowing, and 3 patients had hoarseness. All patients died and the postoperative survival time was 4-13 months, average survival time was 8.5 months. The ultrasonic characters of 6 patients with PSCCT showed that, the size of lesions was large（a maximum diameter of 3.0-5.1 cm）, all of 6 lesions appeared as single solid mixed-echogenicity mass including irregular lamellate marked hypoechoic region, with irregular margin and undefined boundary. Only 2 lesions exhibited microcaleifieation and another 4 lesions had no calcification, 3 lesions exhibited a sign of breakthrough thyroid envelope. Color Doppler flow imaging showed 4 patients had few blood flow and 2 patients had moderate blood flow, a higher vascular resistance spectrum was detected in 5 lesions （RI 0.72-0.88）. 3 patients exhibited abnormal neck lymph node. Conclusions： The characteristic ultrasonic appearance, combined with the clinical features, enables a convincing preoperative diagnosis of PSCCT.

关 键 词：甲状腺 癌 鳞状细胞 超声检查 

分 类 号：R736[医药卫生—肿瘤]