CAJ | 학술논문

目的：观察甲状腺癌患者超声影像特征，通过甲状腺影像学报告及数据系统（Thyroid imaging reporting and data sys-tem，TI-RADS）对甲状腺癌性结节进行分级，期望对甲状腺癌术前定性做出更好预测。方法：将2008年9月至2011年8月天津医科大学总医院收治并经病例证实的甲状腺癌患者160例共235枚病灶纳入研究。对所有患者行常规彩色多普勒超声检查观察病灶的大小、数量、外部形态、边界清晰程度及病变肿块、周围血流分布特征，235个病灶按TI-RADS分级进行评分，评价TI-RADS评分在甲状腺恶性结节的诊断价值。结果：本组病例所示恶性结节176枚，其中形态欠规则，边界不清楚144枚（81.8%），内部不均匀低回声或稍低回声152枚（86.4%），内部探及沙砾样钙化灶144枚病灶（81.8%）。TI-RADS分级评分4、5级160枚（90.91%）， TI-RADS分级评分2、3级16枚（9.09%）。结论：甲状腺彩超声像图中出现边界不清，形态不规则，低回声或稍低回声肿块，肿块内探及沙砾样钙化灶，肿块内部丰富血流信号是诊断甲状腺癌的重要指标，甲状腺癌病灶结节中TI-RADS分级评分为4、5级者有较高阳性率，对甲状腺癌术前定性预测有一定意义。
목적：관찰갑상선암환자초성영상특정，통과갑상선영상학보고급수거계통（Thyroid imaging reporting and data sys-tem，TI-RADS）대갑상선암성결절진행분급，기망대갑상선암술전정성주출경호예측。방법：장2008년9월지2011년8월천진의과대학총의원수치병경병예증실적갑상선암환자160례공235매병조납입연구。대소유환자행상규채색다보륵초성검사관찰병조적대소、수량、외부형태、변계청석정도급병변종괴、주위혈류분포특정，235개병조안TI-RADS분급진행평분，평개TI-RADS평분재갑상선악성결절적진단개치。결과：본조병례소시악성결절176매，기중형태흠규칙，변계불청초144매（81.8%），내부불균균저회성혹초저회성152매（86.4%），내부탐급사력양개화조144매병조（81.8%）。TI-RADS분급평분4、5급160매（90.91%）， TI-RADS분급평분2、3급16매（9.09%）。결론：갑상선채초성상도중출현변계불청，형태불규칙，저회성혹초저회성종괴，종괴내탐급사력양개화조，종괴내부봉부혈류신호시진단갑상선암적중요지표，갑상선암병조결절중TI-RADS분급평분위4、5급자유교고양성솔，대갑상선암술전정성예측유일정의의。
Objective: To retrospectively characterize and analyze the thyroid ultrasound images of thyroid cancer patients, to classify thyroid nodules according to thyroid imaging reporting and data system (TI-RADS), and to evaluate the diagnostic value of TI-RADS. Methods:Clinical data of 160 thyroid cancer patients with 235 nodules from September 2008 to August 2011 were retro-spectively analyzed. All patients underwent conventional color Doppler ultrasonography to evaluate the size, number, shape, boundary, and extent of lesions and blood distribution of the nodules. All nodules were analyzed according to TI-RADS classification and scored to evaluate the diagnostic value of TI-RADS. Results:Among 176 malignant nodules, 144 (81.8%) had lesions showing a mass of irreg-ular boundary with no envelope and halo, 152 (86.4%) were inhomogeneous hypoechoic or slightly hypoechoic, or 144 (81.8%) exhibit-ed microcalcification. TI-RADS scores of 4 or 5 and 2 or 3 were obtained in 160 (90.91%) and 16 (9.09%) of the malignant nodules, re-spectively. Conclusion:Thyroid ultrasound sonogram of ill-defined, irregular shape, hypoechoic or slightly hypoechoic mass, microcal-cification within the mass, and rich blood flow is an important index for the diagnosis of thyroid cancer. Thyroid nodules with a TI-RADS score 4 or 5 have higher possibility for cancer. Therefore, TI-RADS has a significant diagnostic value for thyroid cancer be-fore operation.