彩超诊断甲状腺微小乳头状癌的临床价值

DIAGNOSTIC VALUE OF COLOR DOPPLER ULTRASOUND IN PAPILLARY THYROID MICROCAICINOMA

目的：探讨甲状腺微小乳头状癌（PTNC）的二维声像图及血流分布特征，提高甲状腺结节以及PTMC的超声诊断水平。方法：回顾性分析164例（173个结节）甲状腺乳头状癌病人病灶的数目、形态、边界、内部回声、微小钙化斑、周边回声特征、后方回声、颈部淋巴结等声像图特征及血流分布特征。结果：PTMC的发生率与结节单发还是多发没多大关系；甲状腺结节的二维声像图具有典型特征，表现为纵横比≥1（93．64％）、边界模糊不清（71．10％）、内部回声不均匀（61．27％）、伴微小钙化（62．43％）、周边无声晕或是不完整声晕（100％）；PTMC彩色多普勒血流分布特点Ⅲ～Ⅳ型（56．07％），Ⅰ～Ⅱ型（43．93％）；淋巴结转移发生率较低（6．17％），首先以Ⅵ区即中央区淋巴结转移为多。结论：甲状腺结节超声检查二维声像图特征对微小乳头状癌具有很高的临床应用价值，结合彩色多普勒等高分辨率超声可明显提高甲状腺微小乳头状癌的检出率。

Objective： To investigate the two-dimension ultrasound image and color Doppler ultrasound features of papillary thyroid microcarcinoma（PTMC）. To increase the diagnostic standard in PTMC with ultrasound before surgical operation. Methods：Retrospective analyzing the number, shape, border, internal echo, microcalcification, peripheral echo, echo behind nodes in thyroid, and metastasis of the cervical lateral lymph node. Results：The occurrence of PTMC has no correlation with solitary nodule or multiple nodules. The characteristics of PTMC in two-dimension ultrasound image are A/T ≥ 1 （ 93.64% ）, ill - defined edge （ 71.10% ）, heterogeneous echo （ 61.27% ）, microcalcifications （62.43%） ,absent halo sign （ 100% ） ; color Doppler ultrasound features of PTMC are Ⅰ-Ⅱ型（56.07%）, Ⅲ-Ⅳ型（43.93% ）;metastatic lymph node（6.17% ）,first to the lymph node of Ⅵ region. Conclusions： The two-dimension ultrasound image have high diagnostic value for PTMC, greatly raise the discovering late of PTMC.