Henrichsen Tara L, Reading Carl C, Charboneau J William, Donovan Daniel J, Sebo Thomas J, Hay Ian D
Department of Radiology, Division of Ultrasonography, College of Medicine, Mayo Clinic, 200 1st Street, SW, Rochester, MN 55905, USA.
J Clin Ultrasound. 2010 Sep;38(7):361-6. doi: 10.1002/jcu.20714.
The aim of this study was to determine the prevalence and amount of cystic change in thyroid cancer. This study also examined associated sonographic characteristics of cystic malignant thyroid nodules to help recognize these clinically important nodules.
This study was a retrospective review of 360 malignant thyroid nodules surgically removed at our institution between January 1, 2002 and December 31, 2004. All patients had signed research authorization. All patients had preoperative sonograms and surgical pathologic proof of their thyroid malignancy. The 360 malignant nodules were found in 307 patients. All scans were performed using 7- to 15-MHz transducers, and most studies included a digital video clip of the cancer. The preoperative ultrasound examinations were retrospectively reviewed by three radiologists and a sonographer. An estimate of cystic component percentage was derived by consensus. The presence of a mural nodule, thick irregular wall, microcalcifications, and prominent vascularity was also recorded.
Of the 360 carcinomas, 318 (88.3%) were solid to minimally (less than 5%) cystic, 33 (9.2%) were 6-50% cystic, 9 (2.5%) were 51-100% cystic. Of the nine (2.5%) malignancies that were greater than 50% cystic, all had other suspicious findings including mural nodules, microcalcifications, increased vascularity, and/or a thick irregular wall about the cystic portion.
The vast majority (88%) of thyroid cancer is uniformly solid or has minimal (1-5%) cystic change by sonography. Marked cystic change (>50% of the nodule) occurred in only 2.5% of cancers, which had other sonographic findings worrisome for malignancy.
本研究旨在确定甲状腺癌中囊性变的发生率及程度。本研究还检查了甲状腺囊性恶性结节的相关超声特征，以帮助识别这些临床上重要的结节。
本研究是对2002年1月1日至2004年12月31日期间在本机构手术切除的360个甲状腺恶性结节进行的回顾性分析。所有患者均签署了研究授权书。所有患者术前均进行了超声检查，并经手术病理证实为甲状腺恶性肿瘤。360个恶性结节来自307例患者。所有扫描均使用7至15兆赫的探头进行，大多数研究还包括癌症的数字视频片段。三位放射科医生和一名超声检查技师对术前超声检查进行了回顾性分析。通过共识得出囊性成分百分比的估计值。还记录了壁结节、不规则厚壁、微钙化和显著血管形成的存在情况。
在360例癌肿中，318例（88.3%）为实性至微囊性（小于5%），33例（9.2%）为6%至50%囊性，9例（2.5%）为51%至100%囊性。在9例（2.5%）囊性成分大于50%的恶性肿瘤中，均有其他可疑表现，包括壁结节、微钙化、血管增多和/或囊性部分周围的不规则厚壁。
绝大多数（88%）甲状腺癌在超声检查中表现为均匀实性或仅有微小（1%至5%）囊性变。显著的囊性变（结节的>50%）仅发生在2.5%的癌症中，这些癌症有其他超声表现提示恶性。
