超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的价值

The Diagnostic Value of Ultrasonography for the Nodular Goiter Combined with Papillary Thyroid Microcarcinoma

目的：探讨超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的价值。方法：2010年1月至2014年12月选择来我院进行诊治的结节性甲状腺肿患者80例，病理诊断为结节性甲状腺肿合并甲状腺微小乳头状癌30例（恶性组）和单纯结节性甲状腺肿50例（良性组），都进行常规二维超声、超声弹性成像和超声造影检查。结果：恶性组结节多呈现单发、内部低回声、钙化形态不规则特征，与良性组对比差异有统计学意义（P〈0．05）。恶性组病灶内的血流最小流速明显小于良性组（P〈0．05），阻力指数与搏动指数明显高于良性组（P〈0．05）。良性组弹性成像多为2-3分，恶性组多为4-5分，组间对比差异都有统计学意义（P〈0．05）。恶性组的造影剂平均通过时间明显少于时照组（P〈0．05），两组的显影时间、达峰时间、峰值强度对比差异无统计学意义（P〉0．05）。结论：常规超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的良恶性有一些特异性的征象，超声弹性成像与超声造影可为临床诊断提供补充，有助于提高甲状腺微小乳头状癌的诊断准确率。

Objective： To evaluate the diagnostic value of ultrasonography for the nodular goiter combined with papillary thyroidmicrocarcinoma, Methods： From January 2010 to December 2014, 80 nodular goiter patients were selected in our hospital for diagnosis and treatment. They included the nodular goiter combined with papillary thyroid mierocarcinoma of 30 patients （malignant group） and nodular goiter of 50 patients （benign group）, All patients were carded conventional two-dimensional ultrasound, ultrasound elastography and ultrasound imaging detection. Results： The ultrasound image in the malignant group showed more single, low internal echo, calcification and more irregular features, and the differences were statistically significant compared with that of the benign group （P 〈0. 05）. The minimum blood flow velocity in the malignant group was significantly lower than that of the benign group （P 〈0.05）, and the resistance index and pulsatility index were significantly higher than those of the benign group （P 〈0.05）. The elastography were more 2-3 points in the benign group, and more 4-5 points in malignant group, and the differences were statistically significant between two groups （P 〈0.05）. The average contrast agents transit time in the malignant group were significantly less than that of the control group （P 〈0.05）, the difference in the developing time, peak time, peak intensity were not statistically significant between two groups. Conclusions： Conventional diagnostic ultrasound for nodular goiter combined with papillary thyroid microcarcinoma has some specific signs, and the ultrasound elastography and ultrasound imaging can provide additional clinical diagnosis, help improve the diagnostic accuracy for small papillary thyroid carcinoma.