不同背景下甲状腺微小乳头状癌的常规超声及弹性成像表现

摘要

Objective To investigate the conventional ultrasonic and elastographic characteristics of papillary thyroid micro-carcinomas(PTMC) suffered in normal and Hashimoto's thyroiditis(HT).Methods A total of 227 patients with 249 nodules that were confirmed by surgery or biopsy were included in this study.The cases were divided into normal group and HT group.All patients underwent conventional ultrasound and elastography (static pressure).The sonographic characteristics and strain ratio (SR) value were evaluated.Results In the normal group,the ratio between male and female was 1 ∶ 2.9,while in HT group,it was 1 ∶ 11,which was significant different between the two group (P =0.002).Sonographic characteristics that had no significant difference between the two groups (P ＞0.05) include:boundary,shape,vertical and horizontal ratio,halo,echogenicity,calcification,posterior shadowing,vascularity on color Doppler ultrasonography.The strain ratio value was statistically different between the two groups (P =0.034),with 3.44 ± 1.03 in normal group and 3.13 ± 1.13 in HT group.Conclusions The conventional ultrasonographic features of PTMC were similar in both normal thyroid and HT.However,females suffering HT were more susceptible to PTMC,and the strain ratio value of PTMC concomitant HT decreased.%目的 探讨正常和桥本甲状腺炎(Hashimoto's thyroiditis,HT)背景下,甲状腺微小乳头状癌(Papillary Thyroid Microcarcinoma,PTMC)的常规超声和弹性成像表现.方法 收集经手术和病理证实的PTMC患者227例(249个结节),分为正常背景组和HT背景组,术前均行常规超声和弹性成像(静压式)检查,分析其图像特征以及应变率(strain ratio,SR)比值.结果 正常背景组男女比为1∶2.9,HT背景组的男女比为1∶11,两组的差异具有统计学意义(P=0.002);在结节的边界、形态、纵横比、晕环、内部回声、钙化灶、后方回声和血供等超声征象方面,正常背景组和HT背景组的差异无统计学意义(P＞0.05);正常背景组结节的弹性SR比值为3.44±1.03,HT背景组为3.13±1.13,两组差异有统计学意义(P =0.034).结论 在正常和HT背景下,PTMC结节的多数超声征象表现极其相似,但是女性HT患者更易罹患PTMC,在HT背景下,弹性SR比值降低.