甲状腺转移癌的超声征象

Sonographic Characteristics of Secondary Thyroid Cancer

目的探讨甲状腺转移癌的超声特征。方法回顾性分析本院1988年4月至2013年7月收治的10例甲状腺转移癌患者的临床资料，分析其超声图像及超声报告，记录并总结甲状腺转移癌的超声特征。结果1例肺癌及1例食管癌患者的转移灶表现为甲状腺增jk，弥漫性回声不均，余8例表现为甲状腺结节。8例表现为甲状腺结节的超声特征：5例多发，3例单发；2例病灶累及右侧叶，1例病灶累及左侧叶，5例病灶累及双侧叶；结节平均最大径为3．8Cm（0．6～6．6cm）；5例边界不清，3例边界尚清；7例病灶形态不规则，1例报告中未描述；7例表现为低回声，1例表现为高回声；2例病灶为囊实性，6例表现为实性；6例伴点状、条状强回声，1例无强回声，1例报告中未描述；彩色多普勒血流成像显示：4例病灶内血流丰富，1例周边内部条状血流，1例周边见少许血流信号，1例无血流，1例报告中未描述。甲状腺转移灶与原发病灶具有相似的超声特征。结论甲状腺转移癌超声表现多种多样，多表现为甲状腺结节，也可表现为弥漫性回声不均。结节的超声表现多为多发、体积较大、边界不清、形态不规则、实性、低回声、钙化、血流丰富。了解甲状腺转移癌的超声特征有利于可疑病例的发现。

Objective To investigate the sonographic characteristics of secondary thyroid cancer. Methods The clinical records of 10 patients with histologically proven metastasis to thyroid who were treated in Peking Union Medical College Hospital between April 1988 and July 2013 were retrospectively reviewed. The ultrasound images and reports were reviewed, and the sonographic characteristics of the metastatic thyroid cancer were summarized. Results In 1 patient with lurg cancer and 1 with esophageal cancer, the metastatic lesions were presented as en- larged thyroid gland and uneven diffuse echo; in the remaining 8 patients, thyroid nodules were found. In the 8 lesions, 5 were multiple and 3 were solitary; right lobe was involved in 2 cases, left lobe in 1 case, and both lobes in 5 cases ; the maximal size of the metastatic nodule averaged 3.8 cm （ ranged between O. 6 and 6.6 cm） ; 5 were ill-defined and 3 were well-defined; 7 were irregular and 1 wasn＇t reported; 7 were hypoechoic and 1 was hyperechoic; 6 were solid and 2 were solid and cystic; calcification was observed in 6 cases; rich blood flow was detected in 4 cases, blood flow was detected in internal and peripheral parts of the lesion in 1 case, few blood flow was seen in peripheral part of the lesion in 1 case, and no blood flow in 1 case. The sonographic characteristics of the secondary thyroid cancer were similar to those of the primary tumor. Conclusions The sonographic charac- teristics of secondary thyroid cancer are diverse, among which the thyroid nodule is a common manifestation and un- even diffuse echo can also be observed. The sonographic features that help to identify secondary thyroid cancer include multiple and large lesions, with ill-defined and irregular borders; the mass is solid, hypoechoic, and calcified, with rich blood flow. Ultrasound helps to select suspicious nodule for fine needle aspiration or surgery.