甲状腺癌的超声表现与病理对照分析

Comparison of ultrasonic manifestation and pathology in thyroid cancer

目的探讨甲状腺癌的超声表现并与病理结果进行对照,分析超声对甲状腺癌的诊断价值.方法收集68例接受超声检查的甲状腺癌患者的临床资料.以病理诊断结果为金标准,计算超声诊断的符合率和误诊率,分析超声表现对甲状腺良恶性结节的诊断价值.结果68例患者中,62例患者经超声诊断为甲状腺癌,诊断符合率为91.18%.超声诊断乳头状癌、滤泡状癌的符合率分别为95.74%(45/47)、91.67%(11/12),均高于超声诊断髓样癌的符合率66.67%(6/9),差异均有统计学意义(P﹤0.05).超声表现为甲状腺结节微钙化、后方回声衰减、内部低回声、边界模糊、形态不规则、病灶背景异常、淋巴结肿大、纵横比≥1诊断甲状腺良恶性结节的灵敏度分别为97.62%、96.43%、92.86%、97.62%、96.43%、94.05%、95.24%、96.43%,特异度分别为84.21%、89.47%、52.63%、84.21%、84.21%、73.68%、42.11%、84.21%.68例患者中,0~1级血流19例(27.94%),2~3级血流49例(72.06%),收缩期峰值血流速度(PSV)为(40.86±7.61)cm/s,阻力指数(RI)为(0.71±0.22).结论超声检查可从血流动力学和形态学方面判断甲状腺结节的良恶性,对甲状腺癌的诊断具有重要的临床意义.

Objective To compare the ultrasonic manifestation and pathology in thyroid cancer, and analyze the diagnostic value of ultrasonography. Method Clinical data of 68 patients with thyroid cancer was selected, with all patients received ultrasonography. The conformity and misdiagnosis rate of untrasonography was calculated and its diagnostic value to benign or malignant nodules in thyroid cancer was analyzed by using pathologically diagnostic result as the gold standard. Result In 68 patients, 62 patients were diagnosed with thyroid cancer, and the conformity rate of ultrasonography was 91.18%. The diagnostic conformity rate of papillary carcinoma, follicular carcinoma was 95.74%(45/47) and91.67%(11/12), respectively, both higher than that of medullary carcinoma(66.67%, 6/9)(P<0.05). The sensitivity of ultrasonic manifestation such as microcalcification, posterior echo attenuation, internal hypoecho, blur boundary, irregular morphology, abnormal background of the lesion, lymph node enlargement, aspect ratio ≥1 in the diagnosis of benign and malignant thyroid nodules was 97.62%, 96.43%, 92.86%, 97.62%, 96.43%, 94.05%, 95.24% and 96.43%, respectively,and the specificity was 84.21%, 89.47%, 52.63%, 84.21%, 84.21%, 73.68%, 42.11% and 84.21%, respectively. There were 19 cases(27.94%) with 0-1 grade of blood flow, and 49 cases(72.06%) with 2-3 grade of blood flow. The peak systolic velocity(PSV) was(40.86±7.61) cm/s, and resistance index(RI) was(0.71±0.22). Conclusion It is of important clinical significance for untrosonography to dertermine benign or malignant thyroid nodules by hemodynamics and morphology.