高频超声诊断甲状腺髓样癌的价值  

The value of high frequency ultrasonography in diagnosis of medullary thyroid carcinoma

作　　者：王亮[1] 吕夕明[1] 黄福光[1] 寇红菊[1] 赵智林[1] 王宗敏[2] 

机构地区：[1]温州医科大学附属第二医院超声科,浙江温州325027 [2]温州医科大学附属第二医院病理科,浙江温州325027

出　　处：《肿瘤影像学》2015年第4期264-266,共3页Oncoradiology

摘　　要：目的:探讨高频超声对甲状腺髓样癌的诊断价值。方法:回顾性分析温州医科大学附属第二医院经手术病理证实的21例甲状腺髓样癌患者25个结节的超声表现,包括结节部位、大小、边界、形态、回声水平、内部钙化类型及颈部淋巴结转移情况,并与手术所见及病理学结果对比,分析甲状腺髓样癌的超声图像特点。结果:21例患者中,10例(47.6%)合并其他结节。25个结节中,16个(64.0%)边界较清晰;19个(76.0%)纵横比≤1;16个(64.0%)形态不规则;17个(68.0%)长径>1 cm;17个(68.0%)表现为极低回声;19个(76.0%)病灶内出现钙化,其中粗钙化11个(57.9%)、细小钙化8个(42.1%)。7例(33.3%)患者伴颈部淋巴结转移。超声误诊为结节性甲状腺肿甲状腺影像报告和数据系统(Thyroid Imaging Reporting and Data System,TI-RADS)Ⅲ级者7例(33.3%)。结论:甲状腺髓样癌具有甲状腺恶性肿瘤的一般表现,与乳头状癌相比又有其特殊的声像图表现,即边界较清晰、纵横比≤1、极低回声、粗大钙化灶,易误诊为结节性甲状腺肿。Objective： To investigate the value of high frequency ultrasonography in the diagnosis of medullary thyroid carcinoma（MTC）. Methods： The ultrasound performances of 25 nodules of pathologically confirmed MTC in 21 patients were retrospectively analyzed. The nodular location, size, boundary, shape, echo level, internal calcification type and cervical lymph node metastasis were observed. The results were compared with surgical findings and pathology results. Results： There were 10 cases（47.6%） complicated with other nodules. There were 16 nodules（64.0%） with clear boundaries,19 nodules（76.0%） with aspect ratio less than or equal to 1, 16 nodules（64.0%） with irregular shapes, 17 nodules（68.0%） with diameters greater than 1 cm, 17 nodules（68.0%） with weak echoes. Calcification appeared in 19 nodules（76.0%）, in which 11 nodules（57.9%） with coarse calcifications and 8 nodules（42.1%） with small calcifications. There were 7 cases（33.3%） with cervical lymph node metastasis. Seven cases（33.3%） were misdiagnosed as Thyroid Imaging Reporting and Data System（TI-RADS） Ⅲ nodular goiter by ultrasonography. Conclusion： Compared to papillary carcinoma, MTC has special performances such as clear boundary, aspect ratio less than or equal to 1, weak echo and coarse calcification. It is often misdiagnosed as nodular goiter.

关 键 词：超声检查 甲状腺髓样癌 结节 

分 类 号：R445.1[医药卫生—影像医学与核医学]