甲状腺髓样癌和甲状腺乳头状癌的超声特征比较

Comparison of ultrasonic features between medullary thyroid carcinoma and papillary thyroid carcinoma

目的对比观察甲状腺髓样癌(MTC)和甲状腺乳头状癌(PTC)的超声特征。方法分析27例MTC患者(共33个结节)和187例PTC患者(共200个结节)的声像图特征,包括结节位置、大小、回声水平、内部结构、边界、边缘、形态、纵横比(A/T)、有无钙化及血供情况。结果 MTC结节位于甲状腺中上极,相对较大,呈低回声,内部结构为实性,边界不清,边缘不光整,形态不规则,A/T<1,伴钙化,血供丰富。MTC与PTC结节在位置、大小、边界、边缘、形态、A/T、钙化及血供之间的差异有统计学意义(P均<0.05),回声水平和内部结构间的差异无统计学意义(P均>0.05)。其中15例MTC患者血清降钙素水平有不同程度升高。结论 MTC具有甲状腺恶性结节的一般超声特征,超声可以帮助术前诊断,同时具有一些特异性特征,部分不典型结节容易误诊,需血清降钙素水平共同诊断。

Objective To compare the ultrasonic features between medullary thyroid carcinoma （MTC） and papillary thyroid carcinoma（PTC）. Methods Preoperative sonographic features of 27 patients with MTC （33 nodules） and 187 patients with PTC （200 nodules） were retrospectively reviewed, including position, size, echogenicity, internal structure, border, margin, shape, anteroposterior and transverse diameter ratio （A/T）,calcification and blood supply. Results The main sonographic features of MTC nodules were upper middle location, relatively large size, hypoechogenicity, solid content, unclear border, non-smooth margin, irregular shape, A/T〈[, calcification and rich blood flow, There were significant differences between MTC and PTC in position, size, border, margin, shape, A/T, calcification and blood flow（P〈0.05）, while no significant differences in eehogenicity and internal content （P〉0.05）. Serum calcitonin tested in 15 patients with MTC increased in varying degrees. Conclusion MTC has both general sonographic features of malignant nodules and specific characteristics. Some atypical MTC may be easily misdiagnosed, which should be diagnosed usin~ ultrasonographv and serum ealcitonin.