甲状腺滤泡状腺癌与髓样癌彩超表现和病理研究.docVIP

甲状腺滤泡状腺癌与髓样癌彩超表现和病理研究 　　[摘要] 目的 探讨超声诊断甲状腺滤泡状腺癌和髓样癌的临床应用价值。 方法 2006年1月～2012年12月我院共收治甲状腺滤泡状腺癌和髓样癌患者66例，其中甲状腺滤泡状腺癌38例，髓样癌28例，对上述病例分别进行超声检查。 结果 38例滤泡状甲状腺癌以实质肿块为主（35/38，92.1%），实质肿块表现为等回声（19/35，54.3%）及低回声（16/35，45.7%），边界尚清晰（28例），10例有包膜，不完整低回声晕，未见钙化。甲状腺滤泡状癌的血流分布：0级1例，I级16例，Ⅱ级8例，Ⅲ级13例。血流频谱呈低阻，阻力指数（RI）为0.53～0.58。 甲状腺髓样癌二维声像特征多呈实性低回声，内部分布不均，后方回声衰减，边界不清（14例），无或无完整声晕，结节内可见钙化，特别是沙粒样钙化灶。颈部淋巴结转移多见（71.4%，20/28），且多为双侧。28例患者结节周边及内部均可见较丰富血流信号，周边分布为主，多为断续环状血流，以静脉血流为主，其中0级1例，Ⅰ级4例，Ⅱ级6例，Ⅲ级17例。阻力指数（RI）为0.55～0.82。 结论 超声诊断甲状腺滤泡状腺癌和髓样癌具有便捷、高效、无痛、无创的特点，优势明显，通过超声的声像图特征可以较准确评估病变的特征，并结合病理检查结果为甲状腺癌的诊断提供指导依据。 [关键词] 甲状腺滤泡状腺癌；髓样癌；彩色多普勒超声；病理 [中图分类号] R736.1 [文献标识码] B [文章编号] 2095-0616（2013）22-109-03 The ultrasonography performance and pathological analysis of thyroid follicular carcinoma and medullary carcinoma DONG Yun Ultrasound Department of Shanxi Jinchai Machinery Manufacturing Co.，Ltd.Staff Hospital， Datong 037036， China [Abstract] Objective To investigate the clinical applications value of ultrasound diagnosis for thyroid follicular carcinoma and medullary carcinoma. Methods From January 2006 to December 2012 in our hospital， selected 66 patients with thyroid follicular carcinoma and medullary carcinoma， included 38 cases of thyroid follicular carcinoma and 28 cases， medullary carcinoma and above-mentioned cases were accepted ultrasound examination. Results 38 cases of follicular thyroid cancer were mainly in real mass （35/38， 92.1%）， the real performance was mass echogenic （19/35， 54.3%） and hypoechoic echogenic （16/35， 45.7%）， the border was clear （28 cases）. 10 cases had enveloped， incomplete hypoechoic halo， no calcification. The blood flow distribution of follicular thyroid cancer： 0 grade had 1 case， I grade had 16 cases， Ⅱgrade had 8 cases， Ⅲ grade had 13 cases. Flow spectrum was low resistance， RI=0.53-0.58.The dimensional sonographic features of medullary thyroid carcinoma mostly were solid hypoechoic and internal uneven distribution and posterior echo attenuation， no c