高频超声影像学特征对甲状腺微小乳头状癌侵袭性的诊断

High frequency ultrasound imaging features in the diagnosis of invasive thyroid micro papillary carcinoma

目的探讨高频超声影像学特征对甲状腺微小乳头状癌侵袭性的诊断作用。方法选择2013年1月-2021年1月在浙江省杭州市临平区第一人民医院经超声检查并病理确诊为PTMC的患者100例,并将存在远处淋巴结转移、甲状腺外组织侵犯、远处组织转移、术后复发或死亡病例归为侵袭组25例,其余归为非侵袭组75例,将性别、年龄、结节最长径、有无钙化、有无包膜侵犯、纵横比、是否位于峡部、有无内部囊变、边缘是否规则、是否多发性、结节分布共11项指标纳入单因素分析,P<0.05的指标再纳入多因素Logistic回归分析,得出高频超声影像学特征对甲状腺微小乳头状癌侵袭性的诊断价值。结果年龄<45岁、病灶最长径≥0.6cm、内部有钙化及肿瘤包膜侵犯为预测PTMC具有侵袭性的危险因素(P<0.05)。结论对于年龄<45岁、病灶最长径>0.6cm且内部有钙化灶的患者在检查过程中应重视观察甲状腺包膜连续性是否中断,并仔细扫查双侧颈部淋巴结有无增大。

Objective To investigate the characteristics of high-frequency ultrasound in papillary microcaicinoma PTMC and the clinical value of high-frequency ultrasound in the identification of invasive thyroid microcaicinoma PTMC,and to provide help for the accurate preoperative diagnosis of PTMC.Methods Collected in January 2013 to January 2021 in our hospital by ultrasonic examination and postoperative pathological diagnosis of 100 cases of patients with PTMC,and there will be a distant lymph node metastasis,thyroid tissue invasion and distant metastasis,postoperative recurrence or death cases of invasive group,the rest to return for noninvasive group,and compare the clinical and high-frequency ultrasound features of two groups of lesions.Results There were 25 patients(25%)in the invasive PTMC group and 75 patients(75%)in the non-invasive PTMC group.Compared with the non-invasive PTMC group,the patients in the invasive PTMC group tended to be younger in age and larger in lesion area,with calcification in the lesion and thyroid capsule invasion in some cases.Conclusions For patients with age<45 years old,the longest diameter of lesions>0.6cm and internal calcification foci,attention should be paid to whether the thyroid capsule continuity is interrupted and whether there are enlarged lymph nodes in bilateral neck should be carefully examined during the examination.