弥漫性甲状腺癌超声诊断及研究.doc

弥漫性甲状腺癌超声诊断及研究[摘要] 目的 探讨弥漫性甲状腺癌的超声特点及诊断。方法 将超声表现为甲状腺弥漫团块样回声,后经病理证实为甲状腺癌的6例患者,对其甲状腺形态、大小、内部回声、彩色血流和频谱及颈部淋巴结的超声特点进行对比分析。结果 6例均表现为甲状腺不对称性弥漫性肿大,峡部增厚,内呈弥漫团块样回声,团块边界不清,看不到正常甲状腺组织,双侧颈部淋巴结肿大。甲状腺内血流信号不丰富2例,丰富4例,动脉血流PSV:36～81cm/s,RI:0.64～0.90。4例甲状腺内有细小砂粒样钙化。结论 弥漫性甲状腺癌是少见的超声表现类型。其特点是:甲状腺呈弥漫团块样回声,团块边界不清;细小砂粒样钙化;高速高阻血流及颈部淋巴结转移。 [关键词] 弥漫性; 甲状腺癌; 超声诊断 [中图分类号] R445.1 [文献标识码] A [文章编号] 1673-9701(2009)23-45-02 Ultrasound Diagnosis and Analysis of Diffuse Thyroid Cancer YANG Huiyong The First People’s Hospital of Shangqiu,Henan 476100,China [Abstract] ObjectiveTo investigate the ultrasound characteristics of diffuse thyroid cancer and its diagnosis. MethodsAfter thyroid ultrasound showed diffuse mass-like echo,thyroid cancer was comfirmed in six cases by pathology,and their thyroid morphology,size,internal echo,color flow,spectrum and neck ultrasound features of lymph nodes were compared and analysed. ResultsThe 6 cases showed diffuse thyroid swelling of the asymmetry,thickened isthmus,mass-like echo and unclear mass boundary. The normal thyroid tissue could not be seen,and the swelling of bilateral cervical lymph nodes appeared. Thyroid blood flow signals within the two cases were not rich and those in 4 cases were rich; blood flow was PSV:36～81cm /s and RI:0.64～0.90. There was small sand-like calcification in the thyroid in four cases. ConclusionDiffuse thyroid cancer is a rare type of ultrasound manifestations. Its characteristics are the thyroid with diffuse mass-like echo,unclear boundary mass,small sand-like calcification,high-speed and high-resistant blood flow and neck lymph node metastasis. [Key Words]Diffuse; Thyroid cancer; Ultrasonic diagnosis 甲状腺癌多表现为甲状腺内单发结节,少数为多发结节。本文报告一组声像图表现为甲状腺双侧叶及峡部呈弥漫性肿块样回声,病理证实为甲状腺癌的病例。作者称之为弥漫性甲状腺癌,并对此进行分析。 1 资料与方法 1.1 一般资料 2007年1月～2009年3月,我院经彩色多普勒超声检查,声像图表现为甲状腺弥漫肿块样回声,病理诊断为甲状腺癌的患者6例。男1例,年龄10岁,女5例,年龄43~58岁,平均(48.4±5.9)岁。均以颈部肿大就诊,除一例10岁儿童发现颈部肿大3月余来我院就诊外,其余均有1年以上颈部肿大病史,最长一例达5年余。病理诊断为乳头状腺癌5例,滤泡状腺癌1例。所有病例均经病理证实,有双侧颈部淋巴结