超声诊断甲状腺结节钙化与甲状腺癌相关性分析

A Correlative Analysis of Ultrasound-detected Calcification in Thyroid Nodules and Thyroid Cancer

目的:探讨超声诊断甲状腺结节钙化与甲状腺癌的相关性。方法:回顾性分析玉溪市人民医院2010年1月至2017年10月收治的229例患者甲状腺癌结节的超声声像图,对甲状腺结节内是否存在钙化以及钙化的特征分析并统一标准。结果:恶性结节超声钙化灶的发生率为64.19%(147/229),无钙化灶的发生率为35.81%(82/229),组间比较差异有统计学意义(P<0.05)。恶性结节钙化组中微钙化发生率为95.92%(141/147),显著高于粗钙化、环状钙化的发生率4.08%(6/147),组间比较差异有统计学意义(P<0.05)。结论:甲状腺结节内微钙化对超声诊断甲状腺癌具有较高的临床诊断价值,其他粗大、环状钙化也存在恶性病变的风险,必要时对可疑结节进行细针穿刺细胞学(FNA)检查,可提高诊断的准确性。

Objective: To explore the correlation between ultrasound-detected calcification in thyroid nodules and thyroid cancer. Methods: We conducted a retrospective review of ultrasonic images of thyroid nodules of 229 patients with thyroid cancer hospitalized in the People's Hospital of Yuxi from Jan. 2010 to Oct. 2017, and applied the same criteria to evaluate whether there were ultrasound calcifications in thyroid nodules and analyzed the features of calcification. Results: Ultrasound calcifications were detected in 147 (64.19%)of all cancerous nodules, while in 82 of the 229(35.81%)nodules no ultrasound calcifications were found. The differences between the two groups of data were statistically significant(P<0.05). Among the patients with ultrasound calcifications the incidence of micro- calcifications was 95.92%(141/147), which was clearly higher than the incidence of coarse calcifications and ring calcifications of 4.08%(6/147). There was statistically significant difference(P<0.05). Conclusion: There is a great clinical value in diagnosing thyroid cancer by detecting ultrasound micro-calcifications in thyroid nodules. But the risk of malignant nodules in coarse calcifications and ring calcifications is still high. Thus, in order to promote accurate diagnosis, FNA should be performed on the ultrasonographically suspicious nodules if necessary.