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髓样甲状腺癌的超声特征:与甲状腺乳头状癌和良性甲状腺结节的鉴别。

Ultrasonic Characteristics of Medullary Thyroid Carcinoma: Differential From Papillary Thyroid Carcinoma and Benign Thyroid Nodule.

机构信息

Ultrasound Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

Ultrasound Q. 2021 Apr 12;37(4):329-335. doi: 10.1097/RUQ.0000000000000508.

Abstract

The aim of this study was to evaluate the differences in ultrasonic features of patients with medullary thyroid carcinoma (MTC), papillary thyroid carcinoma (PTC), and benign thyroid nodules. This study included 53 cases of MTC, 151 cases of PTC, and 200 cases of benign thyroid nodule which were pathologically confirmed. There were no significant differences in sex and thyroid gland involvement among the MTC, PTC, and benign thyroid nodule groups. The age among the 3 groups was statistically different (P = 0.002). The TNM stage of MTC was significantly higher than that of PTC (P < 0.001). Compared with PTC, the lesion size, shape, margin, echogenicity, internal nodule component, and blood flow were significantly different in MTC (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P = 0.045, P < 0.001). However, there were no differences in the form of calcification and cervical lymph node involvement between the 2 groups (P = 0.671, P = 0.128). Except for the lesion size and shape (P = 0.068, P = 0.444), MTC group have significant differences in the grade of Thyroid Imaging Reporting and Data System, lesion margin, echogenicity, internal nodule component, calcification, cervical lymph node, and blood flow compared with benign thyroid nodule group (P < 0.001, P = 0.014, P = 0.032, P < 0.001, P < 0.001, P < 0.001). Our data indicate that ultrasound have important value in preoperative diagnosis of MTC. The ultrasonic features of MTC include relatively large nodules, aspect ratio less than 1, smooth edge, solid hypoechoic, microcalcification, and rich blood flow. It is necessary to combine multiple ultrasonic features for the differential diagnosis of MTC, PTC, and benign thyroid nodules.

摘要

本研究旨在评估甲状腺髓样癌(MTC)、甲状腺乳头状癌(PTC)和良性甲状腺结节患者的超声特征差异。本研究纳入了 53 例 MTC、151 例 PTC 和 200 例经病理证实的良性甲状腺结节患者。MTC、PTC 和良性甲状腺结节组之间的性别和甲状腺受累无显著差异。3 组之间的年龄存在统计学差异(P = 0.002)。MTC 的 TNM 分期明显高于 PTC(P < 0.001)。与 PTC 相比,MTC 的病变大小、形状、边界、回声、内部结节成分和血流明显不同(P < 0.001,P < 0.001,P < 0.001,P < 0.001,P = 0.045,P < 0.001)。然而,两组之间的钙化形式和颈部淋巴结受累无差异(P = 0.671,P = 0.128)。除了病变大小和形状(P = 0.068,P = 0.444)外,MTC 组在甲状腺成像报告和数据系统分级、病变边界、回声、内部结节成分、钙化、颈部淋巴结和血流方面与良性甲状腺结节组有显著差异(P < 0.001,P = 0.014,P = 0.032,P < 0.001,P < 0.001,P < 0.001)。我们的数据表明,超声在 MTC 的术前诊断中具有重要价值。MTC 的超声特征包括相对较大的结节、纵横比小于 1、边缘光滑、实质低回声、微钙化和丰富的血流。有必要结合多种超声特征对 MTC、PTC 和良性甲状腺结节进行鉴别诊断。

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