CAJ | 학술논문

目的：对比观察甲状腺髓样癌（MTC）和甲状腺乳头状癌（PTC）的超声特征。方法分析27例MTC患者（共33个结节）和187例PTC患者（共200个结节）的声像图特征，包括结节位置、大小、回声水平、内部结构、边界、边缘、形态、纵横比（A/T）、有无钙化及血供情况。结果 MTC结节位于甲状腺中上极，相对较大，呈低回声，内部结构为实性，边界不清，边缘不光整，形态不规则，A/T＜1，伴钙化，血供丰富。 MTC与PTC结节在位置、大小、边界、边缘、形态、A/T、钙化及血供之间的差异有统计学意义（P均＜0．05），回声水平和内部结构间的差异无统计学意义（P均＞0．05）。其中15例MTC患者血清降钙素水平有不同程度升高。结论 MTC具有甲状腺恶性结节的一般超声特征，同时具有一些特异性特征，部分不典型结节容易误诊，需血清降钙素水平共同诊断。
목적：대비관찰갑상선수양암（MTC）화갑상선유두상암（PTC）적초성특정。방법분석27례MTC환자（공33개결절）화187례PTC환자（공200개결절）적성상도특정，포괄결절위치、대소、회성수평、내부결구、변계、변연、형태、종횡비（A/T）、유무개화급혈공정황。결과 MTC결절위우갑상선중상겁，상대교대，정저회성，내부결구위실성，변계불청，변연불광정，형태불규칙，A/T＜1，반개화，혈공봉부。 MTC여PTC결절재위치、대소、변계、변연、형태、A/T、개화급혈공지간적차이유통계학의의（P균＜0．05），회성수평화내부결구간적차이무통계학의의（P균＞0．05）。기중15례MTC환자혈청강개소수평유불동정도승고。결론 MTC구유갑상선악성결절적일반초성특정，동시구유일사특이성특정，부분불전형결절용역오진，수혈청강개소수평공동진단。
Objective To compare the ultrasonic features between medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma(PTC). Methods Preoperative sonographic features of 27 patients with MTC (33 nodules) and 187 patients with PTC (200 nodules) were retrospectively reviewed, including position, size, echogenicity, internal structure, border, margin, shape, anteroposterior and transverse diameter ratio (A/T),calcification and blood supply. Results The main sonographic features of MTC nodules were upper middle location, relatively large size, hypoechogenicity or marked hypoechogenicity, solid content, unclear border, non-smooth margin, irregular shape, A/T<1, calcification and rich blood flow. There were significant differences between MTC and PTC in position, size, border, margin, shape, A/T, calcification and blood flow(P<0.05), while no significant differences in echogenicity and internal content ( P>0 . 05 ) . Serum calcitonin tested in 15 patients with MTC increased in varying degrees . Conclusion MTC has both general sonographic features of malignant nodules and specific characteristics. Some atypical MTC was easily misdiagnosed, which should be diagnosed using ultrasonography and serum calcitonin.