Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.
AJR Am J Roentgenol. 2010 Apr;194(4):1090-4. doi: 10.2214/AJR.09.3276.
The aim of this study was to evaluate whether sonography can diagnose medullary thyroid carcinoma (MTC) as a malignant lesion using widely accepted sonographic criteria and to compare which sonographic findings of MTC are different from findings for papillary thyroid carcinoma (PTC).
The study included 42 patients (13 men and 29 women; mean age, 48 years) with 46 MTCs and 51 consecutive patients (10 men and 41 women; mean age, 48 years) with 55 PTCs that were confirmed at surgery. Two radiologists retrospectively determined the sonographic diagnoses according to malignant criteria (a taller-than-wide shape, spiculated margin, marked hypoechogenicity, and microcalcifications or macrocalcifications) and compared the sonographic findings of MTCs and PTCs.
MTCs were diagnosed as malignant for 72% of cases by sonography, whereas PTCs were 87% malignant (p = 0.0511). Compared with PTCs, MTCs were larger (mean size, 2.3 +/- 1.5 cm vs 1.1 +/- 1.1 cm) (p = 0.001; odds ratio [OR], 3.84; 95% CI, 1.719-8.565), more frequently showed the presence of a cystic change (33% vs 4%) (p = 0.0226; OR, 0.10; 95% CI, 0.014-0.725), and more commonly showed homogeneous echotexture of the solid portion (59% vs 31%) (p = 0.0004; OR, 0.08; 95% CI, 0.019-0.321). MTCs tended to show an oval shape and circumscribed margin, but there was no statistical significance in multivariate analysis. There were no significant differences in echogenicity, presence, and type of calcification for MTCs and PTCs.
Currently accepted sonographic criteria can be applied for a diagnosis of MTCs. MTCs differ from PTCs in size, presence of a cystic change, and echotexture.
本研究旨在评估超声是否可以使用广泛接受的超声标准诊断髓样甲状腺癌（MTC）为恶性病变，并比较 MTC 的哪些超声表现与甲状腺乳头状癌（PTC）的表现不同。
本研究纳入了 42 例患者（13 名男性和 29 名女性；平均年龄 48 岁），共 46 例 MTC 和 51 例连续患者（10 名男性和 41 名女性；平均年龄 48 岁），共 55 例 PTC，均经手术证实。两位放射科医生根据恶性标准（高宽比、锯齿状边缘、明显低回声和微钙化或大钙化）回顾性确定超声诊断，并比较 MTC 和 PTC 的超声表现。
超声诊断 MTC 为恶性的比例为 72%，而 PTC 为 87%恶性（p=0.0511）。与 PTC 相比，MTC 更大（平均大小 2.3±1.5cm 比 1.1±1.1cm）（p=0.001；优势比[OR]，3.84；95%CI，1.719-8.565），更常出现囊性变（33%比 4%）（p=0.0226；OR，0.10；95%CI，0.014-0.725），更常表现为实性部分均匀的回声（59%比 31%）（p=0.0004；OR，0.08；95%CI，0.019-0.321）。MTC 倾向于呈椭圆形和边界清晰，但多变量分析无统计学意义。MTC 和 PTC 的回声强度、钙化的存在和类型无显著差异。
目前接受的超声标准可用于 MTC 的诊断。MTC 在大小、囊性变和回声纹理方面与 PTC 不同。
