超声鉴别诊断滤泡型甲状腺癌与甲状腺良性结节

Ultrasound in differential diagnosis of follicular thyroid carcinoma and benign thyroid nodules

目的探讨超声鉴别诊断滤泡型甲状腺癌和甲状腺良性结节的价值。方法收集19例滤泡型甲状腺癌(22个结节)、62例甲状腺良性病变(81个结节)包括腺瘤32例(35个结节),结节性甲状腺肿30例(46个结节),均经超声检查,并经手术和病理证实;比较甲状腺良、恶性结节的超声表现。结果滤泡型甲状腺癌与甲状腺良性结节形态、边界、回声水平、钙化、纵横比及弹性评分相似,结节周边晕征、结节内部囊变、结节晕环和结节内部血流分布特点差异有统计学意义(P均<0.05)。在超声弹性成像中,滤泡型癌结节硬度自中央区向周边区增大,表现为结节周边区宽而不均匀的蓝色区带。结论尽管滤泡型甲状腺癌与良性结节的超声表现有一定重叠,但超声仍有助于鉴别诊断甲状腺良、恶性结节。

Objective To observe the value of ultrasound in differential diagnosis of follicular thyroid carcinoma and benign thyroid nodules. Methods Twenty-two nodules of follicular thyroid carcinoma in 19 patients and 81 benign thyroid nodules in 62 patients were included. Among 81 benign nodules, 35 were diagnosed as adenoma in 32 patients, while 46 were diagnosed as nodular goiter in 30 patients. All the nodules were detected with ultrasound and confirmed by surgery inward and pathology. The ultrasonic features of benign and malignant nodules were reviewed and compared. Results Some ultrasonic performances of follicular thyroid carcinoma and benign nodules were similar, including the morphology, border, echo, calcification, aspect ratio and elastic imaging manifestations. However, statistical differences were found in the surrounding halo, internal liquefaction, the characteristics of blood distribution in nodules halo ring and nodules inward （all P〈0. 05）. In addition, ultrasound elasticity imaging showed increasing hardness of follicular carcinoma from center to boundary, exhibiting a wide and heterogeneous blue zone at periphery. Conclusion Though some ultrasonic performances of follicular thyroid carcinoma are similar to benign thyroid nodules, ultrasound is still helpful for differential diagnosis of benign and malignant thyroid nodules.