中华医学超声杂志（电子版）
中華醫學超聲雜誌（電子版）
중화의학초성잡지（전자판）
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2014年
5期
383-387
,共5页
周明炀%费小春%詹维伟%周建桥
週明煬%費小春%詹維偉%週建橋
주명양%비소춘%첨유위%주건교
超声检查%病理学%甲状腺肿瘤%癌,乳头状
超聲檢查%病理學%甲狀腺腫瘤%癌,乳頭狀
초성검사%병이학%갑상선종류%암,유두상
Ultrasonography%Pathology%Thyroid neoplasms%Carcinoma,papillary
目的：探讨甲状腺微小乳头状癌常见超声表现的病理学基础。方法选取2012年1-6月在上海交通大学医学院附属瑞金医院行手术治疗并经病理确诊的甲状腺微小乳头状癌患者共117例，每例患者仅评估1个经病理证实的甲状腺结节，总共评估117个结节。分析超声下结节的形态与边界、内部回声、声晕、后方回声及钙化，镜下肿瘤的浸润程度、内部构成以及钙盐沉积。结果117个甲状腺微小乳头状癌超声下主要表现为形态不规则（87.18%，102/117）、边界不清（80.34%，94/117）、内部低回声（90.60%，106/117）以及微钙化（65.81%，77/117），而镜下主要表现为浸润性生长（93.16%，109/117）、内部以细胞成分为主（46.15%，54/117）以及钙化灶（56.41%，66/117）。镜下呈浸润式生长的109个肿瘤中，102个（93.58%）结节超声表现为形态不规则，91个（77.78%）结节超声表现为边界不清晰。而8个镜下非浸润式生长的肿瘤均为超声表现为形态规则的结节。13个超声下出现声晕的结节中，8个镜下发现了肿块周围有明显的纤维包膜包绕。无论镜下肿瘤内部构成如何，超声下均以低回声结节为主。超声下高回声结节镜下均以细胞成分为主。镜下发现钙化的肿瘤中53.03%（35/66）超声同样探及钙化，46.97%（31/66）超声未探及钙化。镜下未发现钙化灶的肿瘤中82.35%（42/51）超声探及钙化，17.65%（9/51）超声未探及钙化。结论甲状腺微小乳头状癌的超声表现均有其一定的病理学基础，正确认识两者之间的关系将有助于提高超声医师诊断甲状腺结节的准确率。
目的：探討甲狀腺微小乳頭狀癌常見超聲錶現的病理學基礎。方法選取2012年1-6月在上海交通大學醫學院附屬瑞金醫院行手術治療併經病理確診的甲狀腺微小乳頭狀癌患者共117例，每例患者僅評估1箇經病理證實的甲狀腺結節，總共評估117箇結節。分析超聲下結節的形態與邊界、內部迴聲、聲暈、後方迴聲及鈣化，鏡下腫瘤的浸潤程度、內部構成以及鈣鹽沉積。結果117箇甲狀腺微小乳頭狀癌超聲下主要錶現為形態不規則（87.18%，102/117）、邊界不清（80.34%，94/117）、內部低迴聲（90.60%，106/117）以及微鈣化（65.81%，77/117），而鏡下主要錶現為浸潤性生長（93.16%，109/117）、內部以細胞成分為主（46.15%，54/117）以及鈣化竈（56.41%，66/117）。鏡下呈浸潤式生長的109箇腫瘤中，102箇（93.58%）結節超聲錶現為形態不規則，91箇（77.78%）結節超聲錶現為邊界不清晰。而8箇鏡下非浸潤式生長的腫瘤均為超聲錶現為形態規則的結節。13箇超聲下齣現聲暈的結節中，8箇鏡下髮現瞭腫塊週圍有明顯的纖維包膜包繞。無論鏡下腫瘤內部構成如何，超聲下均以低迴聲結節為主。超聲下高迴聲結節鏡下均以細胞成分為主。鏡下髮現鈣化的腫瘤中53.03%（35/66）超聲同樣探及鈣化，46.97%（31/66）超聲未探及鈣化。鏡下未髮現鈣化竈的腫瘤中82.35%（42/51）超聲探及鈣化，17.65%（9/51）超聲未探及鈣化。結論甲狀腺微小乳頭狀癌的超聲錶現均有其一定的病理學基礎，正確認識兩者之間的關繫將有助于提高超聲醫師診斷甲狀腺結節的準確率。
목적：탐토갑상선미소유두상암상견초성표현적병이학기출。방법선취2012년1-6월재상해교통대학의학원부속서금의원행수술치료병경병리학진적갑상선미소유두상암환자공117례，매례환자부평고1개경병리증실적갑상선결절，총공평고117개결절。분석초성하결절적형태여변계、내부회성、성훈、후방회성급개화，경하종류적침윤정도、내부구성이급개염침적。결과117개갑상선미소유두상암초성하주요표현위형태불규칙（87.18%，102/117）、변계불청（80.34%，94/117）、내부저회성（90.60%，106/117）이급미개화（65.81%，77/117），이경하주요표현위침윤성생장（93.16%，109/117）、내부이세포성분위주（46.15%，54/117）이급개화조（56.41%，66/117）。경하정침윤식생장적109개종류중，102개（93.58%）결절초성표현위형태불규칙，91개（77.78%）결절초성표현위변계불청석。이8개경하비침윤식생장적종류균위초성표현위형태규칙적결절。13개초성하출현성훈적결절중，8개경하발현료종괴주위유명현적섬유포막포요。무론경하종류내부구성여하，초성하균이저회성결절위주。초성하고회성결절경하균이세포성분위주。경하발현개화적종류중53.03%（35/66）초성동양탐급개화，46.97%（31/66）초성미탐급개화。경하미발현개화조적종류중82.35%（42/51）초성탐급개화，17.65%（9/51）초성미탐급개화。결론갑상선미소유두상암적초성표현균유기일정적병이학기출，정학인식량자지간적관계장유조우제고초성의사진단갑상선결절적준학솔。
Objective To explore the pathological basic of some common characteristic of papillary microcarcinoma of thyroid in ultrasound. Methods Totally 117 thyroid papillary microcarcinomas that were completed all thyroid ultrasound examinations before the surgical excisions were collected. Shape, border, internal echogenicity, halo, posterior echogenicity and calciifcation were observed in ultrasound. While the degree of inifltration of the tumor, the tumor’s internal structure as well as calciifcation was observed in pathology. Results IIrregular shape (87.18%, 102/117), unclear border (80.34%, 94/117), hypoechoic (90.60%, 106/117) and microcalciifcations (65.81%, 77/117) were recognized by ultrasound while the main pathological features were invasive growth (93.16%, 109/117), cell components internally (46.15%, 54/117) and calciifcation (56.41%, 66/117). Of the 109 neoplasms which were invasive growth in pathology, 102 (93.58%) nodules presented irregular shape in ultrasound while 91 (77.78%) presented unclear border. All of the 8 neoplasms which were not invasive growth in pathology showed regular shape in ultrasound. Thirteen nodules showed halos in ultrasound, and 8 of them showed visible ifbrous capsule surrounding the mass. Whatever the tumor’s internal structure was, most nodules presented hypoechoic. And the hyperechoic nodules were all found cell components internally. Of the 66 neoplasms which were found calciifcation by microscope, 35 (53.03%) nodules showed calciifcation in ultrasound and 31 (46.97%) did not. And of the 51 neoplasms in which calciifcation were not found by microscope, 42 (82.35%) nodules showed calciifcation in ultrasound and 9 (17.65%%) did not. Conclusions There is no doubt that all the performances of papillary microcarcinoma in ultrasound have bases in pathology. It is helpful to the judgment of a thyroid nodule if we could understand the correlation of performances in ultrasound and pathology.
