目的 探讨高频超声诊断甲状腺结节伴蛋壳样钙化的价值.方法 回顾性观察73例经手术病理证实的甲状腺结节伴蛋壳样钙化患者的超声表现,并进行分类:①根据钙化位置分为结节内与结节边缘；②根据钙化表面特征分为光滑钙化与粗糙钙化；③根据钙化形状分为半环形钙化与环形钙化.结果 73例中,恶性结节20例(20/73,27.40％),良性结节53例(53/73,72.60％).钙化位于结节内与结节边缘以及半环形钙化与环形钙化在甲状腺良恶性结节之间差异均无统计学意义,而光滑或粗糙钙化在良恶性结节之间差异有统计学意义.结论 高频超声对于鉴别甲状腺结节伴蛋壳样钙化的良恶性有一定价值,如蛋壳样钙化更多见于良性病灶,但总体作用有限,诊断仍需依靠超声引导下穿刺活检及临床随访.%Objective To observe the value of high frequency ultrasonography in diagnosis of eggshell calcification in thyroid. Methods Sonographic appearances of 73 patients with thyroid nodules associated with eggshell calcification confirmed by post-operation pathology were retrospectively analyzed. Ultrasonic features of eggshell-like calcification were classified as follows: ①calcification into the nodules or around the nodular edge according to location;②smooth eggshell calcification or rough eggshell calcification according to features; ③semi-annular calcification or annular calcification according to shape. Results Among 73 patients, 20 (20/73, 27. 40%) were malignant, 53 (53/73, 72. 60%) were benign nodules. Calcification into the nodules or around nodular edge, as well as semi-annular calcification or annular calcification were not statistically different between benign and malignant thyroid nodules, whereas smooth or rough eggshell calcification were statistically different between benign and malignant nodules. Conclusion Eggshell calcification is more often found in benign thyroid nodules. High-frequency ultrasound has limited value to differential benign and malignant thyroid nodules associated with eggshell calcification. Diagnosis still depends on ultrasound guided biopsy and close follow-up.
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