各种超声征象在不同大小甲状腺乳头状癌诊断价值中的比较  

Comparison the diagnostic value of ultrasonographic features for papillary thyroid carcinoma with different sizes

作　　者：黄雅元 包凌云[1] 韩志江[1] 谷莹[1] 罗定存[1] 

机构地区：[1]浙江省杭州市第一人民医院,浙江杭州310006

出　　处：《中国临床医学影像杂志》2015年第8期558-560,565,共4页Journal of China Clinic Medical Imaging

基　　金：2012杭州市卫生科技计划项目2012A020;2013杭州市重大科技创新专项项目20131813A08

摘　　要：目的：探讨各种超声征象在不同大小甲状腺乳头状癌（Papillary thyroid carcinoma,PTC）诊断价值中的比较。方法：回顾分析经手术及病理证实的279例341枚PTC的超声征象,依据瘤体最大径,将其分为≤1 cm组、〉1-2 cm组和〉2 cm组,分析形态不规则、低回声、纵横比≥1（A/T≥1）和微钙化在各组瘤体中的分布。结果：341枚PTC中,≤1 cm组、〉1-2 cm组和〉2 cm组分别为209枚、87枚和45枚,其中各组形态不规则、低回声、A/T≥1和微钙化分别为84%（175/209）、80%（168/209）、56%（118/209）、46%（97/209）,71%（62/87）、73%（64/87）、42%（37/87）、66%（58/87）,69%（31/45）、35%（16/45）、13%（6/45）、73%（33/45）,形态不规则和微钙化在≤1 cm组和〉1-2 cm组、≤1 cm组和〉2 cm之间均具有统计学差异;低回声在≤1 cm组和〉2 cm组、〉1-2 cm组和〉2 cm组间均具有统计学差异;A/T≥1在≤1 cm组和〉1-2 cm组、≤1 cm组和〉2 cm组、〉1-2 cm组和〉2 cm组之间均具有统计学差异。结论：各种超声征象在不同大小PTC中的分布存在很大差异,正确识别这些差异有助于提高PTC术前诊断准确率,减少误诊的发生。Objective： To investigate the diagnostic value of uhrasonographic features for papillary thyroid carcinoma（PTC） with different sizes. Methods： The uhrasonographic features of 341 PTC nodules in 279 patients which were confirmed by surgery and pathology were analyzed retrospectively. According to the largest tumor diameter, the nodules were divided into three groups： ≤ 1 cm group, 〉1-2 cm group and 〉2 cm group. The distribution of irregular shape, hypoechoic, anteroposterior to transverse diameter ratio≤1 （A/T≥1） and microcalcifications in different groups were evaluated. Results： Among the 341 PTCs, there were 209 cases, 87 cases and 45 cases in ≤1 cm group, 〉1-2 cm group and 〉2 cm group respectively, and in which irregular, hypoechoic, A/T≥1 and microcalcifications were 84%（175/209）, 80%（168/209）, 56%（118/209）, 46%（97/209）; 71%（62/87）, 73%（64/87）, 42%（37/87）, 66%（58/87）; 69%（31/45）, 35%（16/45）, 13%（6/45）, 73%（33/45）. PTCs with irregular shape and microcalcifications in ≤ 1 cm group and 〉1-2 cm groups,≤ 1 cm groups and 〉2 cm group had statistically significant difference; hypoechoic PTCs in ≤ 1 cm group and 〉2 cm group, 〉1-2 cm group and 〉2 cm group had statistically significant difference; PTCs with A/T≥ 1 in ≤ 1 cm group and 〉1-2 cm groups, ≤ 1 cm groups and 〉2 cm group, 〉1-2 cm group and 〉2 cm group had statistically significant difference. Conclusions： There is a significant difference in the distribution of various ultrasonographic features of PTC with different sizes. Correct identification of these differences will help to improve the accuracy of pre-operative diagnosis of PTC and reduce the incidence of misdiagnosis.

关 键 词：甲状腺肿瘤 癌 乳头状 超声检查 

分 类 号：R736.1[医药卫生—肿瘤] R730.261[医药卫生—临床医学]