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
6期
469-473
,共5页
超声检查%甲状腺肿瘤%癌,乳头状,滤泡
超聲檢查%甲狀腺腫瘤%癌,乳頭狀,濾泡
초성검사%갑상선종류%암,유두상,려포
Ultrasonography%Thyroid neoplasms%Carcinoma,papillary,follicular
目的：探讨甲状腺滤泡型乳头状癌（FVPTC）的超声表现。方法绍兴市第七人民医院自2002年3月至2012年12月经手术和病理证实的FVPTC患者30例，分析其超声表现，观察并记录结节的大小、形态、边界、声晕、纵横比、内部回声、微小钙化及颈部淋巴结受累情况，同时结合病理结果进行对照研究。结果30例FVPTC的超声表现可分为3种类型：（1）Ⅰ型6例（20%，6/30），具备乳头状甲状腺癌的典型超声表现，结节形态不规则，边界不清，内部呈极低回声，可见微小钙化；（2）Ⅱ型14例（47%，14/30），结节形态不规则，边缘可见成角或分叶，境界较清晰，内部呈等回声或低回声，较少见微小钙化；（3）Ⅲ型10例（33%，10/30），声像图表现形似腺瘤，结节边界清晰且边缘光整，内部呈均匀中等回声。30例FVPTC患者的镜下结构特征也可相应分为3类：（1）Ⅰ型6例，病灶无明显包膜，形态不规则，呈浸润性生长；（2）Ⅱ型14例，病灶有包膜，形态不规则，病灶对包膜侵犯明显，局部突破包膜，周边可见卫星病灶；（3）Ⅲ型10例，病灶有较为完整的包膜，形态规则，病灶对包膜无明显侵犯或累及程度和范围很小。包膜内型（Ⅱ、Ⅲ型）和非包膜内型（Ⅰ型）FVPTC患者形态、边界、有无声晕、纵横比、内部回声、有无微小钙化比较，差异均有统计学意义（Fisher确切概率法，P均＜0.05）；而包膜内型和非包膜内型FVPTC患者有无淋巴结累及的差异无统计学意义（Fisher确切概率法，P＞0.05）。结论 FVPTC的超声表现兼具滤泡性肿瘤和普通乳头状甲状腺癌的特点，其超声表现与不同的病理亚型有关。
目的：探討甲狀腺濾泡型乳頭狀癌（FVPTC）的超聲錶現。方法紹興市第七人民醫院自2002年3月至2012年12月經手術和病理證實的FVPTC患者30例，分析其超聲錶現，觀察併記錄結節的大小、形態、邊界、聲暈、縱橫比、內部迴聲、微小鈣化及頸部淋巴結受纍情況，同時結閤病理結果進行對照研究。結果30例FVPTC的超聲錶現可分為3種類型：（1）Ⅰ型6例（20%，6/30），具備乳頭狀甲狀腺癌的典型超聲錶現，結節形態不規則，邊界不清，內部呈極低迴聲，可見微小鈣化；（2）Ⅱ型14例（47%，14/30），結節形態不規則，邊緣可見成角或分葉，境界較清晰，內部呈等迴聲或低迴聲，較少見微小鈣化；（3）Ⅲ型10例（33%，10/30），聲像圖錶現形似腺瘤，結節邊界清晰且邊緣光整，內部呈均勻中等迴聲。30例FVPTC患者的鏡下結構特徵也可相應分為3類：（1）Ⅰ型6例，病竈無明顯包膜，形態不規則，呈浸潤性生長；（2）Ⅱ型14例，病竈有包膜，形態不規則，病竈對包膜侵犯明顯，跼部突破包膜，週邊可見衛星病竈；（3）Ⅲ型10例，病竈有較為完整的包膜，形態規則，病竈對包膜無明顯侵犯或纍及程度和範圍很小。包膜內型（Ⅱ、Ⅲ型）和非包膜內型（Ⅰ型）FVPTC患者形態、邊界、有無聲暈、縱橫比、內部迴聲、有無微小鈣化比較，差異均有統計學意義（Fisher確切概率法，P均＜0.05）；而包膜內型和非包膜內型FVPTC患者有無淋巴結纍及的差異無統計學意義（Fisher確切概率法，P＞0.05）。結論 FVPTC的超聲錶現兼具濾泡性腫瘤和普通乳頭狀甲狀腺癌的特點，其超聲錶現與不同的病理亞型有關。
목적：탐토갑상선려포형유두상암（FVPTC）적초성표현。방법소흥시제칠인민의원자2002년3월지2012년12월경수술화병리증실적FVPTC환자30례，분석기초성표현，관찰병기록결절적대소、형태、변계、성훈、종횡비、내부회성、미소개화급경부림파결수루정황，동시결합병리결과진행대조연구。결과30례FVPTC적초성표현가분위3충류형：（1）Ⅰ형6례（20%，6/30），구비유두상갑상선암적전형초성표현，결절형태불규칙，변계불청，내부정겁저회성，가견미소개화；（2）Ⅱ형14례（47%，14/30），결절형태불규칙，변연가견성각혹분협，경계교청석，내부정등회성혹저회성，교소견미소개화；（3）Ⅲ형10례（33%，10/30），성상도표현형사선류，결절변계청석차변연광정，내부정균균중등회성。30례FVPTC환자적경하결구특정야가상응분위3류：（1）Ⅰ형6례，병조무명현포막，형태불규칙，정침윤성생장；（2）Ⅱ형14례，병조유포막，형태불규칙，병조대포막침범명현，국부돌파포막，주변가견위성병조；（3）Ⅲ형10례，병조유교위완정적포막，형태규칙，병조대포막무명현침범혹루급정도화범위흔소。포막내형（Ⅱ、Ⅲ형）화비포막내형（Ⅰ형）FVPTC환자형태、변계、유무성훈、종횡비、내부회성、유무미소개화비교，차이균유통계학의의（Fisher학절개솔법，P균＜0.05）；이포막내형화비포막내형FVPTC환자유무림파결루급적차이무통계학의의（Fisher학절개솔법，P＞0.05）。결론 FVPTC적초성표현겸구려포성종류화보통유두상갑상선암적특점，기초성표현여불동적병리아형유관。
Objective To investigate the ultrasonic features and pathological basis of follicular variant of papillary thyroid carcinoma (FVPTC). Methods Ultrasonic presentation of 30 patients with FVPTC conifrmed by surgery and pathology from the Seventh People′s Hospital of Shaoxing during March 2002 and December 2012 were analyzed retrospectively and compared with pathological results. Results Ultrasonic presentation of 30 FVPTC cases could be classiifed into three types:(1) Six cases (20%, 6/30) of typeⅠ, with typical sonographic features of papillary thyroid carcinoma:nodules with irregular shape, unclear boundary, and very low echo inside, microcalciifcation could be seen. (2) Fourteen cases (47%,14/30) of typeⅡ, presented as clearer iso-echoic or hypo-echoic nodules, with irregular shape, angled and lobular edge, rare microcalciifcation. (3) Ten cases (33%, 10/30) of typeⅢ, presented as adenoma-like features, nodule with clear boundary and regular edge, uniform medium echo inside. The microscopic structure characteristics could be divided into three categories:6 cases of typeⅠ, lesions were featured with no obvious capsule, irregular shape and inifltrative growth;14 cases of type Ⅱ, lesions with irregular shape, which invading the capsule with partial protrusion and peripheral small satellite lesions;10 cases of typeⅢ, lesions with more complete envelope, more regular shape with no signiifcant or lower level and smaller extent invasion of the capsule. Differences in morphology, boundary, aspect ratio, internal echo, presentation of microcalciifcations between the encapsulated type (typeⅡ,Ⅲ) and non-encapsulated type (typeⅠ) FVPTC were statistically signiifcant (Fisher′s exact test, all P<0.05). While the difference in lymph nodes involvement between them was not statistically signiifcant (Fisher′s exact test, both P>0.05). Conclusion Ultrasonic presentation of FVPTC show characteristics of both follicular tumor and papillary carcinoma, and the ultrasonic presentations are closely related to the pathological subtypes.
