不同类型钙化在甲状腺良恶性结节超声鉴别诊断中意义.docVIP

不同类型钙化在甲状腺良恶性结节超声鉴别诊断中的意义 　　摘要：目的 旨在讨论不同类型钙化对甲状腺良恶性结节在超声鉴别诊断中的价值。方法 对经手术治疗的甲状腺结节患者的病理结果与其术前高频超声检查声像图进行回顾性对比研究分析。结果 500例结节中，恶性结节125例，良性结节375例，含钙化结节123个，总钙化率为24.60%，恶性含钙化结节77个，总钙化率为61.60%（77/125），良性含钙化结节46例，总钙化率为12.30%（46/375），恶性结节中含微钙化的甲状腺结节占63.60%（49/77），其中微钙化呈簇状或密集分布的结节22例，占恶性微钙化结节的44.80%（22/49），含粗大钙化的甲状腺结节16例，占恶性结节的20.70%（16/77），边缘环状钙化的甲状腺结节12例，占恶性结节的15.60%（12/77）。结论 含任何类型钙化的甲状腺结节均有恶性的风险，而微小钙化在甲状腺恶性结节中的发生率明显高于良性结节，在甲状腺良恶性结节鉴别诊断中具有特异性，尤其是簇状分布或密集分布的微小钙化结节恶性风险更高，粗大钙化及边缘环状钙化恶性风险虽小于微小钙化，但仍有恶性的风险，应结合甲状腺结节形态、边界、回声及血流分布情况来减少恶性结节漏诊及误诊的发生率。 　　关键词：甲状腺；钙化；微小钙化 　　中?D分类号：R445.1 文献标识码：A 文章编号：1006-1959（2017）25-0181-03 　　Abstract：Objective To discuss the value of different types of calcification in the differential diagnosis of benign and malignant thyroid nodules in ultrasound.Methods The pathological results of surgical treatment of thyroid nodule patients with preoperative high frequency ultrasound sonogram were retrospectively analysed.Results 500 cases of nodules，125 cases of malignant nodules，benign nodules in 375 cases with calcification 123 nodules，the total calcification rate was 24.6%，including 77 malignant nodules，the total calcification rate was 61.6%（77/125），46 cases with benign nodules of calcification，the total calcification rate was 12.3%（46/375），thyroid nodules with microcalcification in malignant nodules accounted for 63.6%（49/77），The microcalcification clusters or dense nodules in 22 cases，accounting for 44.8% of the malignant calcification nodules（22/49），16 cases of thyroid nodules with macrocalcification，accounting for 20.7% of malignant nodules（16/77），12 cases of thyroid nodules in peripheral calcification， accounting for 15.6% of malignant nodules（12/77）.Conclusion Any the type of calcification of thyroid nodules were malignant risk，and microcalcification in thyroid malignant nodules was significantly higher than that of benign nodules，with specificity in the differential diagnosis of benign and malignant thyroid nodules， especially clustered microcalci