甲状腺乳头状癌与甲状腺髓样癌的超声特征对比分析

Comparison of ultrasonic features between papillary carcinoma of the thyroid and medullary carcinoma of the thyroid

目的:对比甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)与甲状腺髓样癌(medullary carcinoma ofthethyroid,MTC)的超声特征。方法:回顾并分析同期经手术后病理学检查证实的20例MTC患者(共30个结节)和167例PTC患者(共183个结节)的术前超声图像及临床病理学资料,对比两组结节声像图特征,包括部位、数目、大小、结构、回声、边缘、形态、钙化、血供及颈部淋巴转移情况等。结果:MTC与PTC相比较,两组在结节部位、大小、边缘、形态、回声、钙化、血供及颈部淋巴结转移方面差异有统计学意义(P均<0.05)。MTC好发于甲状腺中上部而PTC好发于中部;MTC结节较PTC直径大、边缘光整、血流信号较丰富;MTC以平行位多见而PTC以不平行位多见;MTC内部以大钙化多见而PTC内部以点状强回声多见;两组结节回声虽均以低回声为主,但PTC结节回声更具多样性;MTC患者颈部淋巴结转移较PTC多见。两组患者在性别、年龄等方面差异无统计学意义;两组均以单发多见,两组结节结构均以实性或几乎实性为主,差异无统计学意义(P均>0.05)。结论:MTC超声特征与PTC具有一定的重叠性,但也具有一些自身特点,超声检查时应仔细鉴别。

Objective:To compare the ultrasonic characteristics of papillary carcinoma of the thyroid(PTC)and medullary carcinoma of the thyroid(MTC).Methods:Preoperative ultrasonic images and pathological data of 20 patients with MTC(30 nodules)and 167 patients with PTC(183 nodules)were retrospectively analyzed.The ultrasonic features of the nodules in the two groups were compared,including position,number,size,structure,echo,margin,shape,calcification,blood supply and lymph node metastasis of neck.Results:Comparing MTC with PTC,there were significant differences between the two groups in the position,size,margin,shape,echo,calcification,blood supply and lymph node metastasis of neck(P all<0.05).MTC lesions were mainly located in the upper middle of thyroid while PTC lesions were mainly located in the middle.MTC nodules were larger than PTC,with smooth edges and rich blood flow signals.MTC nodules were more common in parallel position and PTC nodules were more common in non-parallel position.Large calcifications were common in MTC nodules and punctate hyperechoics were common in PTC nodules.Although the echoes of nodules in both groups were mainly hypoechoin,the echoes of PTC nodulesss were more diverse.Lymph node metastasis of neck was more common in MTC patients than in PTC.There was no significant difference in gender and age between the two groups.The nodules of two groups were mostly single,and the nodule structures in the two groups were mainly solid or almost solid,with no significant difference(P all>0.05).Conclusion:Ultrasound features of MTC have certain overlap with PTC,but they also have some own characteristics,which should be carefully identified during ultrasound examination.