滤泡亚型甲状腺乳头状癌高频超声诊断  

High Frequency Ultrasound Diagnosis of Follicular Subtype Papillary Thyroid Carcinoma

作　　者：林联合[1] 陈竞函 LIN Lian-he;CHEN Jing-han(Department of Ultrasound Imaging,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian Province,350005 China;Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian Province,350005 China)

机构地区：[1]福建医科大学附属第一医院超声影像科,福建福州350005 [2]福建医科大学附属第一医院口腔颌面外科,福建福州350005

出　　处：《中外医疗》2020年第35期182-185,共4页China & Foreign Medical Treatment

摘　　要：目的研究高频超声对滤泡亚型甲状腺乳头状癌的诊断价值。方法回顾性分析2014年1月—2019年8月于福建医科大学附属第一医院手术病理证实的113例滤泡亚型甲状腺乳头状癌的超声表现,依据是否具有恶性征象,分为具有至少一项恶性征象的类经典型甲状腺乳头状癌组(PTC-like组)和不具有恶性征象的类腺瘤样组(FN-like组),统计分析两组声像特征。结果PTC-like组FV-PTC在结节清晰占比20.8%,形态规则占比22.2%,纵横比>1占比16.7%,有回声区占比4.2%,与N-like组的FV-PTC差异有统计学意义(χ^2=65.496、63.218、5.990、27.262,P<0.05);两组FV-PTC在结界内部有无钙化灶、结节周边有无回声晕、诊断正确率、结节回声高低、结节血流类型、结节最大径线比较上,差异有统计学意义(P<0.05)。PTC-like组的滤泡亚型甲状腺乳头状癌多数结节呈现出典型的PTC的声像特征,即边界不清晰、边缘不规则、微小钙化、低回声、纵横比>1、结节内血流信号不丰富以及结节的径线较小等声像特征;FN-like组的滤泡亚型甲状腺乳头状癌多数结节表现为边界清晰、边缘规则、纵横比<1、结节内有较丰富血流信号、结节周边具有低回声晕、结节的径线较大等声像特征。结论具有典型甲状腺乳头状癌声像特征的滤泡亚型甲状腺乳头状癌超声诊断准确率较高;具有腺瘤声像特征的滤泡亚型甲状腺乳头状癌超声诊断容易误诊,综合全面的临床资料进行判断可以提高诊断准确率;对于类似的腺瘤样甲状腺结节诊断时应谨慎。Objective To study the value of high-frequency ultrasound in the diagnosis of follicular subtype papillary thyroid carcinoma.Methods Retrospective analysis of the ultrasound findings of 113 cases of follicular subtype papillary thyroid carcinoma confirmed by surgery and pathology in the First Affiliated Hospital of Fujian Medical University from January 2014 to August 2019.According to whether they have malignant signs,they were classified as classic papillary thyroid carcinoma group with at least one malignant sign(PTC-like group)and the adenoma-like group with no malignant sign(FN-like group),the acoustic image characteristics of the two groups were statistically analyzed.Results FV-PTC in the PTC-like group accounted for 20.8%of clear nodules,22.2%of morphological rules,16.7%of aspect ratio>1,and 4.2%of echogenic areas,which was different from FV-PTC of N-like group it statistically significant(χ^2=65.496,63.218,5.990,27.262,P<0.05);whether there were calcifications within the boundary of the two groups of FV-PTC,whether there was an echo halo around the nodules,the diagnostic accuracy rate,and the level of nodule echo were statistically significant differences in the type of blood flow of the nodules and the maximum diameter of the nodules(P<0.05).Most nodules of follicular subtype papillary thyroid carcinoma in the PTC-like group showed typical acoustic and image characteristics of PTC,that is,unclear borders,irregular edges,microcalcification,hypoechoic,aspect ratio>1,blood in the nodules insufficient flow signal and small diameter of the nodules,etc.;most nodules of follicular subtype thyroid papillary carcinoma in the FN-like group have clear boundaries,regular edges,aspect ratio<1 Richer blood flow signal,hypoechoic halo around the nodule,large diameter of the nodule,etc.Conclusion The ultrasound diagnosis of follicular subtype of papillary thyroid carcinoma with typical acoustic characteristics of papillary thyroid carcinoma is more accurate;ultrasound diagnosis of follicular subtype of papillary thyro

关 键 词：滤泡亚型甲状腺乳头状癌 高频超声 诊断 

分 类 号：R4[医药卫生—临床医学]