CAJ | 학술논문

目的：评价超声对甲状腺微小乳头状癌与微小结节性甲状腺肿的鉴别诊断价值。方法病例选自2010年8月~2013年7月本院收治的50例甲状腺微小结节患者，经术后病理结果证实，微小乳头状癌28例(结节32个)为观察组，微小结节性甲状腺肿22例(结节25个)为对照组，对比分析两组患者的超声诊断资料，评价超声对两组的鉴别诊断价值。结果观察患者回声情况(低回声/高回声)、形态(规则/不规则)、边界(清晰/模糊)及钙化状况(边缘钙化/微钙化/粗钙化)与对照组比较，差异均有统计学意义(P<0.05)；观察组的动脉收缩期峰值速度(Vmax)及阻力指数(RI)均显著高于对照组(P<0.05)；彩色多普勒检查结果显示，观察组血流丰富程度明显高于对照组(P<0.05)，分型为Ⅱ型的患者比例显著高于对照组(P<0.01)。结论超声对甲状腺微小乳头状癌及微小结节性甲状腺肿具有良好的鉴别诊断价值，临床上应仔细辨别两种疾病的声像特点，以免漏诊、误诊。
목적：평개초성대갑상선미소유두상암여미소결절성갑상선종적감별진단개치。방법병례선자2010년8월~2013년7월본원수치적50례갑상선미소결절환자，경술후병리결과증실，미소유두상암28례(결절32개)위관찰조，미소결절성갑상선종22례(결절25개)위대조조，대비분석량조환자적초성진단자료，평개초성대량조적감별진단개치。결과관찰환자회성정황(저회성/고회성)、형태(규칙/불규칙)、변계(청석/모호)급개화상황(변연개화/미개화/조개화)여대조조비교，차이균유통계학의의(P<0.05)；관찰조적동맥수축기봉치속도(Vmax)급조력지수(RI)균현저고우대조조(P<0.05)；채색다보륵검사결과현시，관찰조혈류봉부정도명현고우대조조(P<0.05)，분형위Ⅱ형적환자비례현저고우대조조(P<0.01)。결론초성대갑상선미소유두상암급미소결절성갑상선종구유량호적감별진단개치，림상상응자세변별량충질병적성상특점，이면루진、오진。
Objective To evaluate the differential diagnosis value of ultrasound on papillary thyroid microcarcinoma and small nodular goiter. Methods From August 2010 to July 2013,50 patients with small nodules in thyroid were se-lected.After confirmation from postoperative pathological results,papillary microcarcinoma in 28 cases with 32 nodules was categorized into the observation group,and small nodular goiter in 22 cases with 25 nodules was classified into the control group.Data from ultrasonic diagnosis in the two groups were compared and analyzed in order to evaluate differ-ential diagnosis value of ultrasound. Results Hypoecho or hyperecho,regular or irregular shape,clear or vague boundary, and calcification dividing into margin calcification,microcalcification and coarse calcification in the observation group displayed statistical differences in comparison with those in the control group (P<0.05).In the observation group,maxi-mal velocity (Vmax) during arterial systole and resistance index (RI) were both higher than those in the control group. The difference after comparisons both displayed statistical significance (P<0.05).Outcomes from color Doppler ultra-sonography in the two groups indicated that blood flow abundance in the observation group was remarkably higher than that in the control group (P<0.05).Among different classifications of papillary thyroid microcarcinoma,proportion of pa-tients in type II was higher in comparison with that in the control group (P<0.01). Conclusion Ultrasound has a favor-able value on differential diagnosis of papillary thyroid microcarcinoma and small nodular goiter.The characteristics of sound image of the two kinds of diseases should be clearly differentiated in clinic in order to avoid missed diagnosis or misdiagnose.