滤泡型甲状腺乳头状癌和经典型甲状腺乳头状癌超声影像对比分析

Comparison of Ultrasonographic Features in Follicular Papillary Thyroid Carcinoma and Classic Papillary Thyroid Carcinoma

目的探讨滤泡型甲状腺乳头状癌(FVPTC)和经典型甲状腺乳头状癌(C-PTC)的超声声像图特征。方法收集我院自2009年1月至2015年6月经手术病理证实的41例FVPTC和54例C-PTC的超声影像资料,结合病理结果回顾性分析并比较两组结节的超声声像图特征。结果 FVPTC组结节平均尺寸大于C-PTC组结节,差异有统计学意义[(18.69±10.73)vs.(13.23±6.41),P<0.05]。C-PTC组术前超声诊断符合率显著高于FVPTC组术前超声诊断符合率(85.2%比56.1%,P<0.05)。FVPTC组与C-PTC组相比,形态规则(48.8%)、边界清晰(61.0%)、等回声(51.2%)、无钙化(53.7%)、有声晕(61.0%)、周边为主型血流(41.5%)在FVPTC组中更常见,形态不规则(51.9%)、边界不清晰(57.4%)、纵横比为≥1(38.9%)、极低回声(40.7%)、微小钙化(48.1%)、无晕(96.3%)、中央为主型血流(53.7%)在C-PTC组中更常见,以上特征FVPTC组与C-PTC组结节比较,差异均有统计学意义(P<0.05)。结论与C-PTC相比,FVPTC有更多良性的超声特征,超声可疑恶性特征的缺乏不能排除FVPTC,需对结节结合多个声像图特征综合判断。

Objective To investigate the uhrasonographic features of follicular papillary thyroid carcinoma （FVPTC）and classic papillary thyroid carcinoma（C-PTC）. Methods We retrospectively analyzed and compared the uhrasonographic features of 41 cases of FVPTC and 54 cases of C-PTC confirmed by surgery and pathology from January 2009 to June 2015. Results The mean nodule size of FVPTC was significantly larger than that of C-PTC（ 18.69 ± 10.73 vs 13.23 ± 6.41 ,P 〈0. 05）. The ultra- sound diagnostic coincidence rate in C-PTC was significantly higher than that in FVPTC （85.2% vs. 56. 1%, P 〈 0. 05 ）. Compared with C-PTC, features like regular shape （48. 8 % ） , clear border （ 61.0% ）, isoecho （ 51.2% ）, non-calcification （ 53.7 % ）, acoustic halo （61.0%）and peripheral blood flow（41.5 % ）were more common in FVPTC. And features like irregular shape （51.9 % ）, un- clear border（57.4% ）, aspect ratio ≥ 1 （ 38.9% ）, very low echo （40. 7% ）, small calcification （48. 1% ）, non-halo （ 96. 3% ） and central blood flow（53.7% ） were more common in C-PTC. The differences above showed significance （ P 〈 0. 05 ）. Conclusion Compared with C-PTC, FVPTC had more benign ultrasonographic features. FVPTC might still be taken into consideration even when the ultrasound examination lacks of malignant features. And it was necessary to combine multiple ultrasonographic features.