TI-RADS分类及超声多普勒血流信号在分化型甲状腺癌中的应用价值  

Application value of TI-RADS classification and ultrasonic Doppler blood flow signal in differentiated thyroid carcinoma

作　　者：张微微[1] 龙春艳[1] 林少建[2,3] 

机构地区：[1]南方医科大学附属南海医院超声科,广东佛山528200 [2]中山大学孙逸仙纪念医院血管甲状腺外科,广东广州510120 [3]广东省恶性肿瘤表观遗传与基因调控重点实验室,中山大学孙逸仙纪念医院,广东广州510120

出　　处：《中国医药科学》2016年第19期18-22,共5页China Medicine And Pharmacy

基　　金：广东省科技计划项目(2012B031800292)

摘　　要：目的通过对分化型甲状腺癌（DTC）患者通过B超检查,采集不同图像特点,根据甲状腺影像学报告和数据系统（TI-RADS）对DTC结节予以分类,并观察此类结节的超声多普勒血流信号,以提高DTC的术前诊断准确率。方法回顾性分析2016年1-6月在南方医科大学附属南海医院进行检查的而且经过该院手术病理证实的DTC患者82例共116枚病灶。观察116枚病灶的超声图像特点并采用TI-RADS分类法对每个结节分类,评价此分类法在诊断DTC结节病理性质中的作用。结果本组研究共有DTC结节99枚,包括微小癌44枚（44.44%）,内部低或极低回声74枚（74.75%）,形态不规则33枚（33.33%）,边界不清40枚（40.4%）,纵横比≥1 38枚（38.38%）,微钙化灶57枚（57.58%）,3型血流信号74枚（74.75%）。在本组82例共116枚结节中,TI-RADS分类4、5类100枚（86.21%）,2、3类16枚（13.79%）。结论在DTC病灶里TI-RADS分类为4、5类的结节所占比例较高,对术前定性及制定治疗方案有一定帮助。甲状腺超声声像图中出现低或极低回声结节,微钙化灶及结节内丰富血流信号是高度提醒结节为DTC的重要参数。Objective Different image features of patients with differentiated thyroid carcinoma were gathered by B ultrasound examination.DTC nodules were classified by thyroid imaging reporting and data system（TI-RADS）.And ultrasonic Doppler blood flow signal of the nodules were observed to improve the accuracy of preoperative diagnosis of DTC. Methods 82 cases of patients with DTC（116 lesions） examined at the South China Sea Hospital Affiliated to Southern Medical University and confirmed by surgery and pathology of the hospital from January 2016 to June 2016 were retrospectively analyzed. The characteristics of ultrasound images of 116 lesions were observed. TI-RADS classification was used to classify each nodule. The role of this classification method in the diagnosis of pathological characteristics of DTC nodules was evaluated. Results This study consisted of 99 DTC nodules, including 44 gold microcarcinoma（44.44%）,74 low or very low echo（74.75%）,33 irregular（33.33%）,40 unclear boundary（40.4%）,38 the aspect ratio ≥ 1（38.38%）,57 micro calcification foci（57.58%）,74 three blood flow signal（74.75%）.In this group of 82 cases of a total of 116 nodules,there were 100 with TI-RADS classification4,5categories（86.21%）,and 16 with TIRADS classification 2,3categories（13.79%）. Conclusion In DTC lesions,the TI-RADS classification of 4, 5 types of nodules have a higher proportion.It is helpful to the qualitative analysis and the treatment plan. Low or very low echo nodules appeared in the ultrasound image of thyroid ultrasound, microcalcifications, and the abundant blood flow signals are the important parameters of DTC.

关 键 词：分化型甲状腺癌 甲状腺影像报告和数据系统 超声多普勒 血流信号 

分 类 号：R581[医药卫生—内分泌]