甲状腺髓样癌的超声诊断价值探讨

Value of ultrasound in the diagnosis of medullary thyroid carcinoma

目的:对甲状腺髓样癌的超声图像进行分析总结,探讨其超声特征,评价其诊断价值,以提高诊断率。方法:回顾性分析2000年1月—2012年12月经手术后病理证实的39例髓样癌患者51个恶性结节。结果:结节多数纵横比<1(80%,41/51);形态不规则(86%,44/51);边界较清晰(63%,32/51);低回声或稍低回声(94%,48/51);钙化多见(62%,33/51)且多样,但仍以微钙化居多(52%,17/33);液化少见(8%,4/51);CDFI以Ⅳ型多见(55%,28/51);RI多<0.70(62%,29/47);弹性成像Ⅱ级或Ⅳ级(50%,6/12)。部分可伴有颈部淋巴结转移(36%,14/39)。结论:髓样癌具有的一些超声特征与乳头状癌、滤泡性肿瘤相类似,注意鉴别。

Objective: To analyze the ultrasonographic(US) features of thyroid medulary carcinoma(MTC), and to discuss the diagnostic value of US. Methods: Between January 2000 and December 2012, 51 malignant lesions proved to be MTC by histopathology in 39 patients were included in the study. Results: An anteroposterior/transverse diameter ratio less than one was seen in most of the nodules(80%). Irregular shape was seen in 44 nodules(86%). Clear border was seen in 32 nodules(63%). Forty-eight nodules were hypoechoic(94%). Calcification was seen in 33 nodules(62%), most of which was microcalcification(52%, 17/33). Degeneration was relatively infrequent. Pattern Ⅳ color flow image was seen in 28 nodules(55%). Pattern Ⅱor Ⅳ in real time elastography was seen in 6 nodules(50%, 6/12). Fourteen patients had cervical metastatic nodules(36%, 14/39). Conclusion: Some US features of MTCs were similar with papillary thyroid carcinoma or follicular tumors.