甲状腺滤泡性腺瘤与滤泡癌的超声检查特征分析

Analysis of ultrasound characteristics of thyroid follicular adenoma and follicular carcinoma

目的 探讨甲状腺滤泡癌(FTC)和滤泡性腺瘤(FA)的临床特点与超声检查表现。方法 选取经病理证实为FTC或FA的157例甲状腺肿瘤患者资料。根据病理结果将其分为FTC和FA两组,并对其超声检查特征进行对照分析。结果 两组在年龄、结节形态、边缘、晕征、回声质地、实性成分的位置、局灶性强回声及血流分级等差异均有统计学意义(P <0.05)。将单因素分析结果有统计学意义的变量(P <0.05)作为自变量纳入多因素logistic回归模型,结果显示模型具有统计学意义(模型χ^(2)=88.54,P <0.001,R^(2)=0.60)。其中结节边缘模糊、周边不规则低回声厚晕征、血流为中央血管型或混合型与FTC诊断密切相关。结论 FTC与FA在超声检查表现上相似性很高,应充分了解其超声检查特征,结节边缘模糊、周边不规则低回声厚晕征、中央血管型或混合型血流是FTC诊断与鉴别诊断的重要征象。

Objective To analyze and compare the clinical features and ultrasonographic manifestations of thyroid carcinoma(FTC)and follicular adenoma(FA),and to improve the diagnostic rate of follicular carcinoma.Methods The clinical and ul-trasonic data of 157 patients with thyroid tumor who were admitted and confirmed as FTC or FA by postoperative pathology were retrospectively analyzed.According to the pathological results,the patients were divided into FTC group and FA group,and their clinical data and ultrasonic characteristics were studied.Results There were statistically significant differences in age,nodule shape,edge,halos,echo texture,location of solid components,focal strong echo and blood flow grading between the two groups(P<0.05).Statistically significant variables(P<0.05)from univariate analysis were incorporated into multivariate logistic re-gression model as independent variables,and the results showed that the model was statistically significant(model χ^(2)=88.54,P<0.001,R^(2)=0.60).Among them,blurred edges of nodules,irregular peripheral hypoechoic thick halo sign,central vessel type or mixed type blood flow were closely related to the diagnosis of FTC.Conclusion FTC and FA are very similar in ultra-sonic images,and their ultrasonic characteristics should be fully understood.Fuzzy nodule edge,irregular peripheral hypoechoic thick halo sign,central vessel type or mixed blood flow are important signs in the diagnosis and differential diagnosis of FTC.