Application value of real-time ultrasound elastography in diagnosis of thyroid papillary carcinoma
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摘要:
目的 探讨甲状腺乳头状癌采用实时超声弹性成像技术的应用价值。 方法 回顾性分析2013年9月~2014年9月入我院进行手术治疗的甲状腺乳头状癌患者、甲状腺良性结节患者各30例,所有患者术前行甲状腺超声诊断技术检查,术后经病理组织标本活检证实为甲状腺乳头状癌、甲状腺良性结节。对两组病理诊断结果、超声图像特点和实时超声弹性成像结果进行对比和分析。 结果 甲状腺乳头状癌结节内的钙化多数为微小钙化,结节边缘毛糙,结节纵横比≥1,差异具有统计学意义(P < 0.05)。乳头状癌组的结节为Ⅳ级的个数明显多于良性结节组,乳头状癌组的结节为Ⅳ级的个数明显多于良性结节组,差异均具有统计学意义(P < 0.05)。 结论 实时超声弹性成像能够准确的评价甲状腺结节的相对硬度,对鉴别甲状腺良、恶性肿瘤及甲状腺乳头状癌具有重要的应用价值。 Abstract:Objective To explore the application value of real time ultrasound imaging technique in thyroid papillary carcinoma. Methods We retrospectively analyzed thyroid papillary carcinoma patients and thyroid benign nodules of our hospital between September 2013 to September 2014, with 30 cases in each group. All the patients before thyroid ultrasound examination and postoperative pathological biopsy specimens confirmed papillary thyroid carcinoma and benign thyroid nodules. The results of pathological diagnosis, ultrasound image features and real-time ultrasound imaging results were compared and analyzed. Results Papillary carcinoma of thyroid nodule calcification most as microcalcification, nodules rough edge, nodular aspect ratio was more than or equal to 1, the difference wa statistically significant (P < 0.05). The number of nodules in the papillary carcinoma group was significantly higher than that in the benign group, and the number of nodules in the papillary carcinoma group was significantly higher than that in the benign group, and the difference was statistically significant (P < 0.05). Conclusion Real time ultrasound imaging can accurately evaluate the relative hardness of thyroid nodules, which has important application value in the differential diagnosis of benign and malignant thyroid tumors and papillary thyroid carcinoma. -
Key words:
- papillary carcinoma of the thyroid /
- real time ultrasound imaging /
- hardness /
- image /
- tubercle
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表 1 两组患者超声图像特征[n(%)]
超声图像 良性结节(n=38) 乳头状癌(n=34) 回声 极低或低回声 10(26.32) 29(85.29) 等回声或高回声 28(73.68) 5(14.71) 边缘 规则 25(65.79) 8(23.53)a 毛糙 4(10.53) 20(58.82)a 模糊 9(23.68) 6(17.65) 形状 卵圆形 29(76.32) 8(23.53) 纵横比≥1 3(7.89) 17(50.00) 不规则 6(15.79) 9(26.47) 回声成分 实性 6(15.79) 31(91.18) 囊实性 11(28.95) 2(5.88) 网格状 17(44.74) 1(2.94) 囊性 4(10.53) 0(0.00) 钙化 微小钙化 1(2.63) 13(38.24)a 粗大钙化 4(10.53) 3(8.82) 弧形钙化及其他 2(5.26) 1(2.94) 淋巴结转移 无 38(100.00) 25(73.53)a 有 0(0.00) 9(26.47)a aP<0.05 vs 良性结节. 表 2 三组患者甲状腺实时超声弹性成像结果[n(%)]
组别 结节数 0~Ⅱ级 Ⅲ级 Ⅳ级 良性结节组 38 36(94.74) 2(5.26) 0(0.00) 乳头状癌组 35 2(5.71) 17(48.57) 16(45.72) -
[1] 李萍, 宋烨, 胡小涛, 等.超声弹性成像与常规超声诊断甲状腺良恶性结节的对照研究[J].同济大学学报:医学版, 2010, 31(3): 88-91. http://www.cnki.com.cn/Article/CJFDTOTAL-TJIY201003025.htm [2] Shweel M, Mansour E. Diagnostic performance of combined elastosonography scoring and high-resolution ultrasonography for the differentiation of benign and malignant thyroid nodules[J]. Eur J Radiol, 2013, 82(6): 995-1001. doi: 10.1016/j.ejrad.2013.02.002 [3] 姜珏, 李苗, 周琦, 等.甲状腺结节的超声弹性成像和常规超声对比分析[J].临床超声医学杂志, 2013, 15(3): 186-8. http://www.cnki.com.cn/Article/CJFDTOTAL-LCCY201303022.htm [4] 罗葆明, 曾婕, 欧冰, 等.乳腺超声弹性成像检查感兴趣区域大小对诊断结果的影响[J].中国医学影像技术, 2007, 23(9): 213-5. http://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX200709023.htm [5] 朱蓓琳, 邬宏恂, 王隽, 等.甲状腺乳头状癌的超声诊断价值探讨[J].中国临床医学影像杂志, 2014, 25(3): 162-4. [6] 顾华云, 邓学东, 郭建锋, 等.甲状腺微小癌的超声诊断及漏诊分析[J].中华医学超声杂志:电子版, 2013, 10(11): 947-50. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHCD201311024.htm [7] Mehrotra P, Mcqueen A, Kolla S, et al. Does elastography reduce the need for thyroid FNAs[J]?. Clin Endocrinol (Oxf), 2013, 78(6): 942-9. doi: 10.1111/cen.2013.78.issue-6 [8] Kazaure HS, Roman SA, Sosa JA. Medullary thyroid microcarcinoma: a population-level analysis of 310 patients[J]. Cancer, 2012, 118(3): 620-7. doi: 10.1002/cncr.26283 [9] 丛淑珍, 冯占武, 甘科红, 等.甲状腺良、恶性结节超声弹性成像特征分析[J].中国医学影像技术, 2010, 26(9): 1682-4. http://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX201009035.htm [10] 邬宏恂, 张冰洁, 戴军, 等.甲状腺乳头状癌超声征象分析[J].中华超声医学杂志, 2013, 29(10): 868-71. [11] Trimboli P, Nasrollah N, Amendola S, et al. Should we use ultrasound features associated with papillary thyroid cancer in diagnosing medullary thyroid cancer[J]. Endocr J, 2012, 59(6): 503-8. doi: 10.1507/endocrj.EJ12-0050 [12] 郝儒田, 张筱骅, 潘贻飞, 等.甲状腺乳头状癌与甲状腺结节钙化关系的探讨[J].中国肿瘤临床, 2007, 20(34): 1178-80. http://www.cnki.com.cn/Article/CJFDTOTAL-ZGZL200720013.htm [13] 李爽, 李茉, 王森, 等.甲状腺乳头状癌诊断的研究进展[J].中国实验诊断学, 2014, 18(11): 1902-4. [14] Saltiki K, Rentziou G, Stamatelopoulos K, et al. Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression[J]. Eur J Endocrinol, 2014, 171(1): 117-26. doi: 10.1530/EJE-14-0076
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