超声诊断甲状腺囊性乳头状癌

Ultrasound in diagnosis of thyroid cystic papillary carcinoma

目的分析甲状腺囊性乳头状癌的超声表现。方法收集经病理诊断为甲状腺囊性乳头状癌的94例患者(94个病灶)的超声和临床资料,分析其超声图像特征。结果 94个病灶中,结节最大径(25.41±13.07)mm,结节内偏心性无回声区93个(93/94,98.94%);纵横比≥1者30个(30/94,31.91%);形态不规则70个(70/94,74.47%);边界不清59个(59/94,62.77%);以实性成分为主77个(77/94,81.91%),液性为主17个(17/94,18.09%);实性成分为低回声74个(74/94,78.72%),内部出现微钙化89个(89/94,94.68%);甲状腺被膜浸润45个(45/94,47.87%);Alder血流评级0级19个(19/94,20.21%),1级43个(43/94,45.74%),2级25个(25/94,26.60%),3级7个(7/94,7.45%),平均血流速度(31.23±2.57)cm/s;66个结节行CEUS,表现为不均匀低增强55个(55/66,83.33%);49个结节行弹性成像,平均弹性应变率比值3.41±1.62。超声诊断淋巴结转移准确率56.41%(22/39);诊断甲状腺囊性乳头状癌准确率73.40%(69/94)。结论甲状腺囊性乳头状癌超声表现具有一定的特征性,有助于该病的诊断。

Objective To analyze the ultrasound findings of thyroid cystic papillary carcinoma.Methods Clinical and ultrasonic data of 94 thyroid cystic papillary carcinoma patients including 94 lesions confirmed by pathology were collected,the ultrasonic manifestations were analyzed.Results In 94 lesions,the mean maximum diameter was(25.41±13.07)mm,93 lesions(93/94,98.94%)were with eccentric echogenic areas;30 lesions(30/94,31.91%)were with vertical/horizontal≥1;70 lesions(70/94,74.47%)were with irregular shape;59 lesions(59/94,62.77%)had unclear boundary;77 lesions were(77/94,81.91%)mainly solid ingredients and 17 lesions(17/94,18.09%)were mainly cystic components;74 lesions(74/94,78.72%)were hypoechoic,89 lesions(89/94,94.68%)were with internal calcification;45 lesions(45/94,47.87%)were with thyroid capsule invasion;Alder blood flow rating displayed level 0 of 19 lesions(19/94,20.21%),level 1 of 43 lesions(43/94,45.74%),level 2 of 25 lesions(25/94,26.60%),level 3 of 7 lesions(7/94,7.45%);the average blood flow velocity was(31.23±2.57)cm/s;low inhomogeneous enhancement was on 55 lesions(55/66,83.33%);the average elastic strain rate ratio was 3.41±1.62.The accuracy of ultrasound diagnosis of lymph node metastasis was 56.41%(22/39);the accuracy of diagnosis of thyroid cystic papillary carcinoma was 73.40%(69/94).Conclusion Ultrasound images of thyroid cystic papillary carcinoma have certain characteristics,which is helpful in the diagnosis.