Leclère J, Sidibé S, Lassau N, Gardet P, Caillou B, Schlumberger M, Romaniuk C, Parmentier C
Département d'Imagerie, Institut Gustave-Roussy, Villejuif, France.
J Radiol. 1996 Feb;77(2):99-103.
The aim of this study was to describe the different ultrasonic features of hepatic metastases of medullary thyroid carcinoma and to point out two particular patterns.
A retrospective review of the sonographic examinations of 35 patients with hepatic metastases from medullary thyroid carcinoma was performed. The metastases were classified relatively to their size and sonographic appearance.
Four ultrasonic types of metastases were described: Type I: small (< 3 cm) hyperechoic nodules with the same features as typical hepatic hemangioma (54%); Type II: markedly hyperechoic micronodules often associated with acoustic shadowing (40%); Type III: hyperechoic nodules of more than 3 cm in diameter (14%) corresponding to advanced intrahepatic disease; Type IV: hypoechoic or in target form nodules (28%) rarely isolated (8%), mostly associated with additional hyperechoic lesions (20%). Thirty two out of 35 patients had hyperechoic nodules; in 22 patients the HM were of a single type, mainly type I (n = 12) and in 13 patients different types of nodules were present. These sonographic features were correlated with the histologic characteristics of medullary thyroid carcinoma. No precise relationship could be establish between the histologic form of MTC and the US features.
The authors underline the possible mistake between the metastases of type I and the hemangioma and the characteristic appearance of metastases of type II.
本研究旨在描述甲状腺髓样癌肝转移的不同超声特征，并指出两种特殊模式。
对35例甲状腺髓样癌肝转移患者的超声检查进行回顾性分析。根据转移灶的大小和超声表现进行分类。
描述了四种超声类型的转移灶：I型：小（<3cm）高回声结节，具有与典型肝血管瘤相同的特征（54%）；II型：明显高回声微结节，常伴有声影（40%）；III型：直径大于3cm的高回声结节（14%），对应肝内晚期病变；IV型：低回声或靶形结节（28%），很少孤立出现（8%），大多与其他高回声病变相关（20%）。35例患者中有32例有高回声结节；22例患者的肝转移灶为单一类型，主要为I型（n = 12），13例患者存在不同类型的结节。这些超声特征与甲状腺髓样癌的组织学特征相关。甲状腺髓样癌的组织学类型与超声特征之间无法建立精确的关系。
作者强调I型转移灶与血管瘤之间可能存在的误诊以及II型转移灶的特征性表现。
