高频超声与增强CT对甲状腺髓样癌的诊断价值比较

Comparison of accuracy in diagnosis of medullary thyroid carcinoma between high frequency ultrasound and enhanced computed tomography

目的比较高频超声与增强CT对甲状腺髓样癌(MTC)的诊断价值。方法对手术病理证实为MTC的46例患者术前高频超声与增强CT影像学资料进行比较,包括病灶部位、大小、边界、形态、内部钙化类型及颈部淋巴结转移情况等。再将两种检查方法的诊断结果与术后病理检查结果作对照,比较两者诊断准确率。结果手术病理学检查结果:46例MTC患者肿瘤侵及一叶甲状腺35例、两叶甲状腺11例;累及峡部7例;肿瘤直径(2.2±1.3)cm;合并其他结节9例;伴颈部淋巴结转移27例;远处转移7例。高频超声检查对MTC的诊断准确率为72.7%,明显高于增强CT检查的58.2%(P<0.05)。结论高频超声检查对MTC具有较高的诊断准确率,同时具有方便、廉价、无辐射等优点,可作为目前诊断MTC的首选影像学方法。

Objective To compare the accuracy of high frequency ultrasonography(HFUS)with enhanced computed tomography(CT)in diagnosis of medullary thyroid carcinoma(MTC).Methods Clinical data of 46 patients with MTC undergoing surgical treatment were retrospectively analyzed.The preoperative imaging findings of HFUS and enhanced CT were compared,including the nodular location,size,boundary,shape,internal calcification type,cervical lymph node metastasis.Using pathological results as gold standard the diagnostic accuracy of two imaging methods were evaluated.Results There were 55 medullary carcinoma lesions of 46 patients.Malignancy invaded one lobe of thyroid in 35 cases,two lobes in 11 cases,involved the isthmus in 7 cases.The mean diameter of the lesions was(2.2±1.3)cm.Calcification occurred in 33 lesions,the thyroid cancer was combined with other nodules in 19 cases.Cervical lymph node metastasis occurred in 27 cases and distant metastasis occurred in 7 cases.The diagnostic accuracy of HFUS and enhanced CT was 72.7%and 58.2%respectively(P<0.05).Conclusion HFUS is a convenient,inexpensive and noninvasive method for thyroid carcinoma with higher diagnostic accuracy than enhanced CT.It can be used as the first choice of imaging modality to guide the treatment algorithms.