中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2018, Vol. 40 ›› Issue (3): 378-384.doi: 10.3881/j.issn.1000-503X.2018.03.014

• 论著 • 上一篇    下一篇

甲状腺乳头状癌微钙化高分辨率超声特征分析

田艳1,鲁瑶2,赵玉珍3,史艳芬4,郑敏3,李建初1()   

  1. 1 中国医学科学院 北京协和医学院 北京协和医院超声医学科,北京 100730
    2 中日友好医院 乳腺甲状腺外科,北京 100029
    3 中日友好医院 超声科,北京 100029
    4 中日友好医院 病理科,北京 100029
  • 收稿日期:2017-11-10 出版日期:2018-06-30 发布日期:2018-07-05

Characteristics of High-resolution Ultrasound in the Assessment of Microcalcification of Papillary Thyroid Carcinoma

TIAN Yan1,LU Yao2,ZHAO Yuzhen3,SHI Yanfen4,ZHENG Min3,LI Jianchu1()   

  1. 1 Department of Ultrasound,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    2 Department of Breast and Thyroid Surgery, China-Japan Friendship Hospital,Beijing 100029,China
    3 Department of Ultrasound, China-Japan Friendship Hospital,Beijing 100029,China
    4 Department of Pathology,China-Japan Friendship Hospital,Beijing 100029,China
  • Received:2017-11-10 Online:2018-06-30 Published:2018-07-05

摘要:

目的 探讨17 MHz高频线阵探头对甲状腺乳头状癌微钙化的检出情况及病理学基础。方法 分析2016年1月至2017年1月在中日友好医院就诊的经超声检查和手术病理确诊的75例甲状腺乳头状癌患者的临床资料,比较17 MHz高频超声与常规超声对微钙化检出率,对比分析声像图上与病理显微镜下微钙化表现。结果 93个甲状腺结节中,17 MHz超声对甲状腺乳头状癌微钙化的检出率为74.2%(69/93),明显高于常规超声的59.1%(55/93)(χ 2=4.742,P=0.029)。常规超声和17 MHz超声对甲状腺结节微钙化的诊断敏感度、特异度、准确度、阳性预测值、阴性预测值分别为73.6%和98.1%、60.0%和57.5%、67.7%和80.6%、70.9%和75.4%、63.1%和95.8%。病理显微镜下观察发现53个结节有钙化,其中10个结节发现砂粒体;砂粒体均存在于细胞团中,而不规则钙盐沉积几乎都存在于增生的纤维组织中。结论 17 MHz高频超声扫描对甲状腺结节微钙化的检出率高于常规超声;声像图上微钙化并不完全对应于病理显微镜下砂粒体,还有纤维条索上的不规则钙盐沉积。

关键词: 甲状腺, 高频超声, 微钙化, 病理

Abstract:

Objective To investigate the role of 17-MHz high-frequency linear array probe in detecting the microcalcification of papillary thyroid carcinoma (PTC) and its pathological basis.Methods The clinical data of 75 patients with PTC diagnosed by ultrasonography and pathology in China-Japan Friendship Hospital from January 2016 to January 2017 were analyzed. The detection rate of microcalcification was compared between 17-MHz high-frequency ultrasound and conventional ultrasound,and the imaging findings and pathological results were analyzed.Results Among 93 thyroid nodules,the detection rate of PTC microcalcification by 17-MHz ultrasound was 74.2% (69/93),which was significantly higher than that of conventional ultrasound (59.1%,55/93) (χ 2=4.742,P=0.029). The diagnostic sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of the conventional ultrasound and the 17-MHz ultrasound were 73.6% and 98.1%,60.0% and 57.5%,67.7% and 80.6%,70.9% and 75.4%,and 63.1% and 95.8%,respectively. Pathology confirmed the presence of microcalcification at 53 nodules,among which psammoma bodies were found in 10 nodules;in addition,all the psammoma bodies were located in the cell mass,whereas irregular calcium deposits were mainly in proliferated fibrous tissues.Conclusions The 17-MHz high-frequency ultrasound can increase the detection rate of microcalcification in thyroid nodules. The ultrasonic manifestations of microcalcification do not completely correspond to the psammoma bodies found in pathology;rather,they may represent the irregular calcium deposits on fibrous tissues.

Key words: thyroid, high frequency ultrasound, microcalcification, pathology

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