探讨甲状腺微小乳头状癌的超声诊断价值  

To Explore the Ultrasonic Diagnostic Value of Thyroid Papillary Microcarcinoma

作　　者：黄春燕[1] Huang Chunyan(Department of Ultrasound,Foshan Hospital of Traditional Chinese Medicine,Guangzhou University of Traditional Chinese Medicine,Foshan,Guangdong 528000)

机构地区：[1]广州中医药大学附属佛山市中医院超声科,广东佛山528000

出　　处：《现代医用影像学》2020年第7期1198-1201,共4页Modern Medical Imageology

摘　　要：目的:分析甲状腺微小乳头状癌的超声影像表现,探讨超声在甲状腺微小乳头状癌方面的诊断价值。方法:回顾性收集本院2018年1—2020年2月经病理证实为甲状腺微小乳头状癌患者60例,总结超声影像特点,并与术后病理结果对照分析超声诊断的准确度、灵敏度和特异度。结果:在60例甲状腺微小乳头状癌中,单发45例,发生于甲状腺左叶30例,甲状腺右叶15例;甲状腺两叶多发15例。超声影像表现为实质内较低回声结节36例,形态不规则及边界模糊48例,病灶纵横比>1者33例,甲状腺低回声结节伴砂粒样钙化24例。彩色多普勒超声显示血流信号为Ⅱ和Ⅲ型者30例。伴有淋巴结转移15例。超声诊断甲状腺微小乳头状癌的准确度为80.0%(48/60),敏感度为81.8%(27/33),特异度为77.8%(21/27)。结论:彩色多普勒超声能显示甲状腺内小结节的血流信号,能提高超声诊断甲状腺微小乳头状癌的准确度、敏感度及特异度,有望作为临床诊断甲状腺乳头状癌的首选检查方法。Objective:To analyze the ultrasonographic manifestations of thyroid papillary microcarcinoma and explore the diagnostic value of ultrasonography in thyroid papillary microcarcinoma.Methods:60 cases of thyroid papillary microcarcinoma confirmed pathologically in our hospital from January 2018 to February 2020 were collected retrospectively,the characteristics of ultrasound images were summarized,and the accuracy,sensitivity and specificity of ultrasound diagnosis were analyzed in comparison with postoperative pathological results.Results:Among the 60 cases of papillary thyroid microcarcinoma,45 cases were solitary,30 cases occurred in the left lobe of thyroid gland and 15 cases occurred in the right lobe of thyroid gland.There were 15 cases with multiple thyroid lobes.Ultrasound images showed 36 cases of hypoechoic nodules,48 cases of irregular shape and fuzzy boundary,33 cases of lesions with aspect ratio>1,and 24 cases of thyroid hypoechoic nodules with sand-like calcification.Color Doppler ultrasound showed blood flow signals of typeⅡandⅢin 30 cases.15 cases were accompanied by lymph node metastasis.Ultrasound diagnosis of thyroid papillary microcarcinoma has an accuracy of 80.0%(48/60),sensitivity of 81.8%(27/33)and specificity of 77.8%(21/27).Conclusion:Color Doppler ultrasound can display the blood flow signals of thyroid nodules,which can improve the accuracy,sensitivity and specificity of ultrasound diagnosis of thyroid papillary microcarcinoma.It is expected to be the first choice for clinical diagnosis of thyroid papillary carcinoma.

关 键 词：甲状腺肿瘤 微小乳头状癌 超声诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]