甲状腺木乃伊结节和甲状腺乳头状癌的超声表现分析  

Ultrasonographic features of thyroid mummy nodule and thyroid papillary carcinoma

作　　者：张丽丽[1] 谭小蕖[1] 温泉 刘玉江[1] 钱林学[1] ZHANG Li-li;TAN Xiao-qu;WEN Quan(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院超声科,北京100050

出　　处：《临床和实验医学杂志》2024年第6期641-644,共4页Journal of Clinical and Experimental Medicine

基　　金：首都卫生发展科研专项项目(编号:首发2022-1-2022)。

摘　　要：目的探讨甲状腺木乃伊结节和甲状腺乳头状癌(PTC)的超声表现,以期更准确地诊断甲状腺木乃伊结节,从而减少不必要的甲状腺穿刺活检或外科手术治疗。方法回顾性收集2016年1月至2023年7月间首都医科大学附属北京友谊医院收治的具有可疑超声征象的甲状腺结节患者80例作为研究对象。经甲状腺细针抽吸活检证实为甲状腺木乃伊结节40例,PTC 40例,分别作为木乃伊结节组、PTC组。对两组患者结节的二维超声特征(包括大小、回声、形态、边界、钙化、黑白双层晕环征、血流信号等)及其超声造影表现进行比较分析。结果木乃伊结节组结节的边界清晰、形态规则、无钙化、有黑白双层晕环征超声特征的患者比例分别为57.5%、60.0%、55.0%、37.5%,均高于PTC组(25.0%、22.5%、17.5%、0),差异均有统计学意义(P<0.05);两组间纵横比比较,差异无统计学意义(P>0.05)。两组间在结节回声构成上比较差异有统计学意义(P<0.05),木乃伊结节和PTC均更容易表现为低回声。而在血流方面比较,木乃伊结节更多表现为周边和内部无血流信号,两组间在血流分布上比较,差异有统计学意义(P<0.05)。木乃伊结节组与PTC组患者行超声造影,两组间造影特点比较,差异有统计学意义(P<0.05)。木乃伊结节多表现为整体无增强,而PTC多表现为低或等增强。结论PTC更容易出现点样钙化、边界模糊,而黑白双层晕环征易出现在甲状腺木乃伊结节中,结节内部无血流,超声造影无增强等超声特征,将有助于提高甲状腺木乃伊结节的诊断,从而避免过度诊断及不必要的穿刺活检。Objective To explore the ultrasonographic features of thyroid mummy nodule and thyroid papillary carcinoma(PTC)to diagnose thyroid mummy nodule more accurately,reduce unnecessary thyroid biopsy or surgery.Methods A total of 80 patients with suspected ultrasound signs of thyroid nodules admitted to Beijing Friendship Hospital,Capital Medical University from January 2016 to July 2023 were retrospectively collected as research subjects.Forty cases of thyroid mummy nodules and 40 cases of PTC were confirmed by fine needle aspiration,as the mummy nodule group and PTC group,respectively.The two-dimensional ultrasound features(including size,echo,shape,boundary,calcification,black and white halo ring sign,blood flow and so on)and contrast-enhanced ultrasound features of the two groups were compared and analyzed.Results The rates of patients with clear boundaries,regular morphology,no calcification,and ultrasound features of black and white double halo ring in the mummy nodule group were 57.5%,60.0%,55.0%,and 37.5%,respectively,which were higher than those in the PTC group(25.0%,22.5%,17.5%,0),and the differences were statistically significant(P<0.05).There was no statistically significant difference in the aspect ratio between the two groups(P>0.05).There was also a statistically significant difference in the composition of nodule echogenicity between the two groups(P<0.05),and both mummy nodules and PTC were more likely to exhibit low echogenicity.In terms of blood flow,mummy nodules were more likely to show no blood flow signals in the periphery and interior,and the difference in blood flow distribution between the two groups was statistically significant(P<0.05).The patients in the mummy nodule group and PTC group underwent contrast-enhanced ultrasound,and the differences in contrast characteristics between the two groups were statistically significant(P<0.05).Most mummy nodules revealed no enhancement in thyroid nodules,while PTC nodules showed heterogeneous hypo-enhancement or isoenhancement.Conclusion Poorly defin

关 键 词：甲状腺 乳头状癌 木乃伊结节 黑白双层晕环征 

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]