甲状腺髓样癌的超声鉴别诊断及临床意义

Analysis of ultrasonic differential diagnosis and clinical significance of medullary thyroid carcinoma

目的总结甲状腺髓样癌的超声特征。方法回顾性分析经病理证实的40例甲状腺髓样癌(42个结节)的超声声像图特征,以甲状腺乳头状癌(40例,44个结节)和良性结节(结节性甲状腺肿,44例,48个结节)做对照。结果甲状腺髓样癌超声主要表现为低或极低回声(92.86%),实性(90.48%),位于中上极(76.19%),呈圆形或卵圆形(61.90%),边界清晰(59.52%),微小钙化多见(70.00%);与甲状腺乳头状癌相比,甲状腺髓样癌多呈圆形或椭圆形,边界清晰,回声均匀,内部血流丰富,易发生淋巴结转移。结论甲状腺髓样癌超声表现不同于乳头状癌,呈圆形或椭圆形,边界清晰,位于中上极,容易与甲状腺良性结节相混淆。

OBJECTIVE To summar ize the ultrasonographic(US) features of medullary thyroid carcinoma(MTC).METHODS The ultrasonographic characteristics of 40 medullary thyroid carcinoma(42nodules) confirmed by pathology were retrospectively reviewed.For comparison,ultrasound appearances of 40 papillary thyroid carcinoma(PTC)(44 nodules) and 44 nodular goiter(48 benign thyroid nodules) were evaluated also.RESULTS The common US findings of MTCs were hypoechogenicity(including marked hypoechogenicity)(92.86%),internal solid content(90.48%),nodules in middle and upper parts of the thyroid(76.19%),ovoid or round shape(61.90%),well defined border(59.52%),and microcalcifications(70.00%).Compared with PTCs,MTCs tended to show ovoid or round shape,well defined border,enlarged lymph nodes on the neck,homogeneous echo,abundant blood flow.CONCLUSION Ultrasound characteristics of medullary thyroid carcinoma is different from that of papillary thyroid carcinoma.It is usually ovoid or round shape,well defined border and in the middle and upper part of the thyroid.It should be pay more attention to differential diagnosis with MTCs and benign thyroid nodules.