桥本甲状腺炎背景下甲状腺微小乳头状癌的超声表现探讨

Ultrasonographic features of papillary thyroid microcarcinoma associated with Hashimoto' sthyroiditis

目的 :探讨桥本甲状腺炎(Hashimoto's thyroiditis,HT)背景下甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)的超声表现特点。方法 :回顾87例HT患者共90个经手术病理证实的甲状腺微小结节,分析其超声表现特征,包括结节的内部结构、回声水平、纵横比、形态、边界、声晕、微钙化、血供模式及血供程度。采用χ2检验及Fisher确切概率法比较HT背景下PTMC与良性微小结节的超声特征差异。结果:90个甲状腺微小结节术后经病理证实,其中59个为PTMC,31个为良性结节。PTMC与甲状腺微小良性结节间的微钙化、血供模式及血供程度差异有统计学意义(P<0.05);而两者间的内部结构、回声水平、纵横比、形态、边界、声晕差异均无统计学意义(P>0.05)。结论:超声检查对HT背景下PTMC病灶具有一定诊断价值,结节内的微钙化和血流情况可能有助于PTMC与良性病灶间的鉴别诊断。

Objective To characterizethe uhrasonographic features of papillary thyroid microcarcinoma （PTMC） in patients with Hashimoto＇s thyruiditis （HT）. Methods A total of 90 small thyroid nodules with pathological confirmation in 87 patients with HT were analyzed. The uhrasonographic features of nodules were evaluated, including internal structure, echo level, nodule aspectratio, shape, border, acoustic halo, microcalcification, vascular pattern and extent of the blood supply. Chi-square test and Fisher＇s exact probability method were used to compare the differences in uhrasonographic features between benign nodules and PTMCs. Results Among 90 thyroid nodules, 59 were PTMCs and 31 were benign nodules.Ultrasonographic features such as microcaleification, vascular pattern and extent of the blood supply differed significantly between PTMC and benign nodules （P〈0.05）. There were no statistical differences in internal structure, echo level, nodule aspeetratio, shape, border and acoustic halo between PTMC and benign nodules （P〉0.05）. Conclusions Ultrasonography could be used for differentiating PTMC from benign nodules in patients with HT, and nhrasonographic features such as microcaleification and blood supply might be helpful for the diagnosis of PTMC.