甲状腺乳头状癌与髓样癌的超声图像特征比较

Comparison of ultrasound features of papillary thyroid carcinoma and medullary carcinoma

目的:比较甲状腺乳头状癌与髓样癌的超声图像特征。方法:回顾性分析2018年10月至2020年10月该院收治的40例甲状腺乳头状癌患者的临床资料作为乳头状癌组,40例甲状腺髓样癌患者的临床资料作为髓样癌组。比较两组二维超声图像和弹性成像图像特征。结果:髓样癌组二维超声图像特征多表现为卵圆形和实性回声,乳头状癌组多表现为纵横比≥1,且以实性回声为主,部分可呈囊实性回声;髓样癌组病灶分级多为Ⅳ级,乳头状癌组多为Ⅲ级。两组二维超声图像的病灶面积测量值比较,差异无统计学意义(P>0.05);髓样癌组弹性成像图像的病灶面积测量值高于乳头状癌组,差异有统计学意义(P<0.05)。结论:超声下甲状腺乳头状癌形状不规则,纵横比≥1,呈现一定的囊实性改变,甲状腺髓样癌多为卵圆形和实性改变;弹性成像下甲状腺乳头状癌多为Ⅲ级,甲状腺髓样癌多为Ⅳ级,且弹性超声下甲状腺髓样癌的病灶面积测量值高于甲状腺乳头状癌。

Objective: To compare ultrasound features of papillary thyroid carcinoma and medullary carcinoma. Methods: The clinical data of 40 patients with papillary thyroid carcinoma admitted to the hospital from October 2018 to October 2020 were retrospectively analyzed and they were set as papillary carcinoma group, and the clinical data of 40 patients with medullary thyroid carcinoma admitted to the hospital during the same period were analyzed and were used as medullary carcinoma group. The characteristics of two-dimensional ultrasound images and elastography images were compared. Results: The two-dimensional ultrasound images of the medullary carcinoma group were characterized by oval and solid echoes.The papillary carcinoma group showed an aspect ratio ≥ 1, and was dominated by solid echoes, some of which could be cystic and solid echoes.The medullary carcinoma group was mostly grade Ⅳ, while the papillary carcinoma group was mostly grade Ⅲ. There was no significant difference in the measurement value of lesion area between the two groups(P<0.05). The lesion area measurement value of elastography image in medullary carcinoma group was higher than that in papillary carcinoma group, and the difference was statistically significant(P<0.05). Conclusions: The ultrasound image of papillary thyroid carcinoma shows irregular shape, aspect ratio ≥1, and a certain cystic and solid changes, while medullary thyroid carcinoma is mostly oval and shows mostly solid changes. Under elastography, papillary thyroid carcinoma is mostly grade Ⅲ, awhile medullary thyroid carcinoma is mostly grade Ⅳ. Further, the area measurement level of medullary thyroid carcinoma under ultrasonic elastography is higher than that of papillary thyroid carcinoma.