甲狀腺癌的診治现状.ppt

甲状腺癌的诊治现状;参考文献;;甲状腺癌;几个概念;*;甲状腺癌的发病率;甲状腺癌的发病率;美国1989-2008年每年新发病例数;*;发病率上升的病理类型构成;中国天津的20年统计资料： 1、发病率显著增长 2、女性增长最显著 3、发病率随年龄增长 4、25、55岁2个快速增长段 5、死亡率随年龄增长;复发与死亡风险;;甲状腺癌的危险因素;甲状腺癌的危险因素;甲状腺癌的危险因素;甲状腺癌的危险因素;影像学在甲状腺癌诊断中的进展;影像学在甲状腺癌诊断中的进展;甲状腺囊肿（无血流）;影像学在甲状腺癌诊断中的进展;Transverse sonogram of a 35-year-old man with a hypoechoic solid papillary thyroid carcinoma (arrowheads) with numerous punctate echogenic foci with no acoustic shadow representing microcalcifications. This nodule also has a partial hypoechoic halo. ;Papillary carcinoma in a 27-year-old woman with a palpable mass. Sagittal view of the left lobe of the thyroid gland shows a large, solid mass containing psammomatous calcifications, suspicious for papillary carcinoma. Cytology of a fine-needle aspirate confirmed the diagnosis. ;Papillary carcinoma. US of the thyroid gland shows an irregular, solid, hypoechoic nodule (arrows) containing some coarse calcifications (curved arrow).;Longitudinal sonogram of a 39-year-old woman with a papillary thyroid carcinoma with peripheral, “egg-shell calcifications” casting an acoustic shadow which obscures other sonographic features of this nodule.;Longitudinal sonogram of a 47-year-old man with a papillary thyroid carcinoma metastasis to a cervical lymph node (arrowheads). Numerous punctate microcalcifications are clearly seen. ;A, Longitudinal sonogram of a 35-year-old woman with a solid papillary thyroid carcinoma (arrowheads) with mixed echo texture and a partial, hypoechoic halo. ;;影像学在甲状腺癌诊断中的进展;影像学在甲状腺癌诊断中的进展;CT检查;影像学在甲状腺癌诊断中的进展;影像学在甲状腺癌诊断中的进展;甲状腺核素扫描;高功能甲状腺腺瘤;影像学在甲状腺癌诊断中的进展;气管移位;;细针穿刺活检（FANB）;甲状腺细针穿刺检查;;;Photomicrographs of Specimens of Thyroid Nodules Obtained by FNAB A : a benign hyperplastic nodule (colloid adenoma). B : an atypical adenoma C : a Hurthle-cell tumor. D : a follicular carcinoma E : a papillary carcinoma. ;FBAN适应症;;甲状腺癌的治疗方法;初始治疗的目标;甲状腺癌的手术治疗;甲状腺癌手术方式选择;全/近全甲状腺切除术;;甲状腺腺叶+峡部切除;;淋巴结清扫;颈部淋巴结分区;2008～2011年国内报道手术方式;I131在甲状腺癌治疗中的意义;I131治疗适应证;;I131治疗前的准备;甲状腺抑