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)
2013年
6期
484-488
,共5页
超声检查%甲状腺肿瘤%腺瘤
超聲檢查%甲狀腺腫瘤%腺瘤
초성검사%갑상선종류%선류
Ultrasonography%Thyroid neoplasms%Adenoma
目的探讨甲状腺滤泡癌的超声声像图特征。方法回顾性分析经手术病理证实的36例甲状腺滤泡癌患者(微浸润型滤泡癌31例,广泛浸润型滤泡癌5例)及52例甲状腺滤泡性腺瘤患者的临床及超声声像图资料,供分析的超声声像图参数包括:肿瘤大小(最大直径)、声晕、囊性成分比例、实性成分回声类型及均匀性、钙化情况和结节个数,临床参数包括患者的年龄和性别。采用t检验(患者年龄、肿瘤最大直径)或χ2检验(囊性成分比例、声晕、实性成分回声类型及均匀性、钙化情况、结节个数和患者的性别)分析各参数在甲状腺滤泡癌和甲状腺滤泡性腺瘤间的差别。结果甲状腺滤泡癌以实性为主(100.0%,36/36),多呈低回声(69.4%,25/36),实性成分回声多不均匀,呈斑片状等回声及低回声相间改变(83.9%,26/32),超过一半的滤泡癌内部及周边可见钙化灶(55.6%,20/36),周围多表现为无明显声晕或声晕薄厚不均(69.4%,25/36);而甲状腺滤泡性腺瘤则以囊实混合性或囊性为主(61.5%,32/52),实性成分多呈等回声(63.5%,33/52),内部回声多较均匀(80.8%,42/52),伴钙化少见(7.7%,4/52),声晕存在且多薄而均匀(86.5%,45/52)。以上特征甲状腺滤泡癌与甲状腺滤泡性腺瘤比较,差异均有统计学意义(χ2=34.813、28.596、35.256、25.052、28.811,P均<0.01)。甲状腺滤泡癌与甲状腺滤泡性腺瘤患者平均年龄、肿瘤最大直径比较,差异均无统计学意义(t=0.222、-1.228,P=0.825、0.223)。甲状腺滤泡癌患者中肿瘤最大直径>40 mm所占比例为22.2%(8/36)、单个结节的比例为31.3%(12/24)、男性比例为25.0%(9/27)、年龄>45岁者的比例为66.7%(24/36),与甲状腺滤泡性腺瘤的17.3%(9/52)、21.2%(11/41)、23.1%(12/40)和71.2%(37/52)相比,差异均无统计学意义(χ2=0.330、1.635、0.043、0.201,P均>0.05)。结论甲状腺滤泡癌患者的超声声像图特征为肿瘤偏实性、回声较低、回声欠均匀、存在钙化以及声晕厚薄不均。
目的探討甲狀腺濾泡癌的超聲聲像圖特徵。方法迴顧性分析經手術病理證實的36例甲狀腺濾泡癌患者(微浸潤型濾泡癌31例,廣汎浸潤型濾泡癌5例)及52例甲狀腺濾泡性腺瘤患者的臨床及超聲聲像圖資料,供分析的超聲聲像圖參數包括:腫瘤大小(最大直徑)、聲暈、囊性成分比例、實性成分迴聲類型及均勻性、鈣化情況和結節箇數,臨床參數包括患者的年齡和性彆。採用t檢驗(患者年齡、腫瘤最大直徑)或χ2檢驗(囊性成分比例、聲暈、實性成分迴聲類型及均勻性、鈣化情況、結節箇數和患者的性彆)分析各參數在甲狀腺濾泡癌和甲狀腺濾泡性腺瘤間的差彆。結果甲狀腺濾泡癌以實性為主(100.0%,36/36),多呈低迴聲(69.4%,25/36),實性成分迴聲多不均勻,呈斑片狀等迴聲及低迴聲相間改變(83.9%,26/32),超過一半的濾泡癌內部及週邊可見鈣化竈(55.6%,20/36),週圍多錶現為無明顯聲暈或聲暈薄厚不均(69.4%,25/36);而甲狀腺濾泡性腺瘤則以囊實混閤性或囊性為主(61.5%,32/52),實性成分多呈等迴聲(63.5%,33/52),內部迴聲多較均勻(80.8%,42/52),伴鈣化少見(7.7%,4/52),聲暈存在且多薄而均勻(86.5%,45/52)。以上特徵甲狀腺濾泡癌與甲狀腺濾泡性腺瘤比較,差異均有統計學意義(χ2=34.813、28.596、35.256、25.052、28.811,P均<0.01)。甲狀腺濾泡癌與甲狀腺濾泡性腺瘤患者平均年齡、腫瘤最大直徑比較,差異均無統計學意義(t=0.222、-1.228,P=0.825、0.223)。甲狀腺濾泡癌患者中腫瘤最大直徑>40 mm所佔比例為22.2%(8/36)、單箇結節的比例為31.3%(12/24)、男性比例為25.0%(9/27)、年齡>45歲者的比例為66.7%(24/36),與甲狀腺濾泡性腺瘤的17.3%(9/52)、21.2%(11/41)、23.1%(12/40)和71.2%(37/52)相比,差異均無統計學意義(χ2=0.330、1.635、0.043、0.201,P均>0.05)。結論甲狀腺濾泡癌患者的超聲聲像圖特徵為腫瘤偏實性、迴聲較低、迴聲欠均勻、存在鈣化以及聲暈厚薄不均。
목적탐토갑상선려포암적초성성상도특정。방법회고성분석경수술병리증실적36례갑상선려포암환자(미침윤형려포암31례,엄범침윤형려포암5례)급52례갑상선려포성선류환자적림상급초성성상도자료,공분석적초성성상도삼수포괄:종류대소(최대직경)、성훈、낭성성분비례、실성성분회성류형급균균성、개화정황화결절개수,림상삼수포괄환자적년령화성별。채용t검험(환자년령、종류최대직경)혹χ2검험(낭성성분비례、성훈、실성성분회성류형급균균성、개화정황、결절개수화환자적성별)분석각삼수재갑상선려포암화갑상선려포성선류간적차별。결과갑상선려포암이실성위주(100.0%,36/36),다정저회성(69.4%,25/36),실성성분회성다불균균,정반편상등회성급저회성상간개변(83.9%,26/32),초과일반적려포암내부급주변가견개화조(55.6%,20/36),주위다표현위무명현성훈혹성훈박후불균(69.4%,25/36);이갑상선려포성선류칙이낭실혼합성혹낭성위주(61.5%,32/52),실성성분다정등회성(63.5%,33/52),내부회성다교균균(80.8%,42/52),반개화소견(7.7%,4/52),성훈존재차다박이균균(86.5%,45/52)。이상특정갑상선려포암여갑상선려포성선류비교,차이균유통계학의의(χ2=34.813、28.596、35.256、25.052、28.811,P균<0.01)。갑상선려포암여갑상선려포성선류환자평균년령、종류최대직경비교,차이균무통계학의의(t=0.222、-1.228,P=0.825、0.223)。갑상선려포암환자중종류최대직경>40 mm소점비례위22.2%(8/36)、단개결절적비례위31.3%(12/24)、남성비례위25.0%(9/27)、년령>45세자적비례위66.7%(24/36),여갑상선려포성선류적17.3%(9/52)、21.2%(11/41)、23.1%(12/40)화71.2%(37/52)상비,차이균무통계학의의(χ2=0.330、1.635、0.043、0.201,P균>0.05)。결론갑상선려포암환자적초성성상도특정위종류편실성、회성교저、회성흠균균、존재개화이급성훈후박불균。
Objective To determine sonographic features of thyroid follicular carcinoma ( FC) in comparison with thyroid follicular adenoma ( FA ).Methods This retrospective study included 36 pathologically proven FCs (5 widely invasive FCs and 31 minimally invasive FCs)and 52 FAs in 88 patients who underwent thyroid surgery .We analyzed clinical features of each patient ,including patient gender,age, and sonographic features of each tumor , including maximum diameter, peripheral halo, echogenicity, echotexture,calcifications and nodule number .These clinical and sonographic findings were compared by using t test ( age and diameter ) or the χ2 test (sex ratio,halo,echogenicity,echotexture,calcifications and nodularity)between FAs and FCs.Results For sonographic features,predominantly solid content(100.0%, 36/36),hypoechoic echogenicity (69.4%,25/36),inhomogeneous echotexture (83.9%,26/32),presence of calcifications(55.6%, 20/36) and without or with irregular halo (69.4%,25/36) were more commonly found in FCs.In comparison,FAs were more likely to present with mixed or predominantly cystic content (61.5%,32/52),isoechoic echogenicity (63.5%,33/52),homogeneous echotexture (80.8%,42/52), absence of calcifications (7.7%,4/52) and thin halo (86.5%,45/52) ( χ2 =34.813,28.596,35.256, 25.052,28.811,all P<0.01).The maximum diameter and mean age did not show statistically significant difference between FCs and FAs (t=0.222,-1.228,P=0.825,0.223).The proportions of tumor larger than 40 mm(22.2%,8/36 vs 17.3%,9/52),solitary nodule(31.3%,12/24 vs 21.2%,11/41),male sex (25.0%,9/27 vs 23.1%,12/40)and patient older than 45 years(66.7%,24/36 vs 71.2%,37/52)did not show statistically significant difference between FCs and FAs ( χ2 =0.330,1.635,0.043,0.201,all P>0.05).Conclusion Sonographic features,including predominantly solid content ,hypoechoic echogenicity, inhomogeneous echotexture ,presence of calcifications and without or with irregular halo were more commonly seen in FCs.