甲状腺癌的高频及彩色多普勒超声特征

High frequency and color Doppler ultrasonography for the diagnosis of thyroid carcinoma

目的探讨高频及彩色多普勒超声在甲状腺癌诊断中的价值.方法对29例经手术病理证实的甲状腺癌患者的高频及彩色多普勒超声声像图进行回顾性分析.结果术前超声检出占位性病变29例,其中超声提示占位性病变性质待定8例,误诊为腺瘤2例.术后病理证实为甲状腺乳头状癌21例,滤泡性癌6例,髓样癌2例.甲状腺癌高频超声声像图特征:呈实质杂乱回声伴微钙化斑16例;呈均匀低回声型边界尚清楚、边缘毛糙8例,其中3例瘤体纵横径比值＞1;3例呈囊实混合型;2例显示不规则晕环的不均匀回声型.彩色多普勒超声:肿块较大者血流较多,微小肿块血流较少或不能显示血流.结论高频及彩色多普勒超声在甲状腺癌诊断中有很好的临床应用价值.

Objective To evaluate the value of high frequency and color Doppler ultrasonography in the diagnosis of thyroid carcinoma. Methods Twenty-nine patients with thyroid carcinoma were retrospec- tively reviewed by means of high frequency ultrasound and color Doppler flow imaging （CDFI）. The diagnosis of thyroid carcinoma was confirmed by pathology after operation. Results Preoperatively, 29 patients who underwent ultrasound were shown to have space-occupying lesions. Among them, 8 patients had the lesions to be identified and 2 were misdiagnosed with adenoma. Postoperative pathology confirmed thyroid papillary carcinoma in 21 cases, follicular carcinoma in 6 and medullary carcinoma in 2. The diagnoses by ultrasound agreed with the pathologic findings in 21 cases, and 2 cases were misdiagnosed as adenoma. The uhrasonographic features of the 29 cases of thyroid carcinoma were as follows： heterogeneous solid echoes with micro-calcifications in 16 cases; homogeneous solid low echoes, with a coarse edge, well defined wall in 8 cases, of whom 3 cases had length/breadth diameter ratio 〉 1 ; cystic-solid mixed echoes in 3 cases ; and irregular circular heterogeneous echoes in 2 cases. CDFI revealed that larger lesion had more blood supply, while smaller lesion had less or no blood supply. Conclusion High frequency and color Doppler ultrasonog- raphy is of great clinical value in the diagnosis of thyroid carcinoma.