甲状腺癌声像图特征及误诊分析

Ultrasonographic characteristics of thyroid carcinoma and analysis of the misdiagnosed cases

目的分析甲状腺癌的超声特征，探讨误诊原因，提高超声对甲状腺癌的诊断率。方法对353例经手术及病理证实的甲状腺癌病例术前超声诊断资料进行回顾性分析，并比较≤10mm与〉10mm者声像图特征。结果353例甲状腺癌患者共416个病灶，术前超声准确诊断350个，误诊66个，诊断符合率为84．13％，误诊率为15．87％。形态、回声强度、边界及钙化情况在≤10mm与〉10mm的结节之间差异具有统计学意义。结论结节的大小是影响诊断准确性的重要因素之一；部分甲状腺癌与良性病变表现相似或与良性病变共存，导致误诊。

Objective To analyze the ultrasonographic characteristics of thyroid carcinoma in order to improve the accuracy of ultrasound in the diagnosis of thyroid cancers. Methods Ultrasonographic characteristics of thyroid carcinoma in 353 patients were retrospectively analyzed, which were substantiated by pathologic operation and the ultrasonographic characteristics of the nodules with diameter of 10 mm or less and larger than 10 mm were compared. Results There were 416 nodules in the 353 cases,350 nodules of which were correctly diagnosed preoperatively, 66 nodules misdiagnosed. The diagnose accordance rate was 84.13%, the misdiagnosis rate was 15.87%. Some characteristics including shape, echogenicity, boundary and calcification were significantly different between the nodules with diameter of 10 mm or less and larger than 10 mm. Conclusions The size of nodules is an important factor impacting the diagnostic accuracy. There are overlaps between benign and malignant characteristics and sometimes carcinomas were concomitant with benign nodules,which cause some misdiagnosis.