滤泡型甲状腺乳头状癌的声像图与病理基础对照研究

Comparative analysis of the ultrasonography and pathology of the follicular variant of papillary thyroid carcinomas

目的深入地认识滤泡型甲状腺乳头状癌(PTC)的超声表现,减少滤泡型PTC的误诊率。方法回顾性分析我院39个经病理证实为滤泡型PTC的术前超声图像指标(形态、边界、声晕、内部回声、钙化及肿瘤的血管分布状况),并与指标相应的组织病理学进行对比分析。结果 39个滤泡型PTC超声表现:形态光整33个、边界清楚30个、周边见声晕29个、实性低回声结节27个,砂粒样钙化17个,混合血管型20个;病理结果:瘤体几乎为滤泡细胞,且间质少(82.0%),可见包膜(25.6%)及砂粒体(30.8%);与病理结果对比,超声误诊率为71.8%。结论滤泡型PTC的病理基础决定了其超声多表现为:实性低回声、边界清、形态规则、可伴砂粒样钙化。

Objective To recognize the ultrasonography of follicular variant of papillary thyroid carcinomas （PTC）, and to reduce the misdiagnosis rate of PTC. Methods The preoperative sonography of 39 patients with thyroid carcinoma confirmed by pathology was analyzed retrospectively.The sonographic features including shape, boundary,internal echo, calcification, vascular distribution and hypoechoic halo of nodules were analyzed. Results The sonography of PTC demonstrated oval shape（33/39,84.6% ）, well-defined margins（30/39,76.9%）,hypoechogenicity（27/39,69.2%）, hypoechoic halo（29/39,74.4%）, microcalcifications（ 17/39, 43.6% ） and mixed vascula type （ 20/39,30.7% ） ; Pathology results showed tumors were almost consisted of follicular cells and rarely stroma（82.0% ）,visible capsule（25.6% ） and psammoma bodies（30.8% ）.Compared with the pathological results, ultrasound misdiagnosis rate was 71.8%. Conclusion PTC pathological foundation determines its sonography： solid, hypoechogenicity, clear boundary, oval shape, may be associated with microcalcification.