甲状腺结节钙化模式诊断甲状腺癌的价值

摘要

目的 评价超声探测甲状腺结节钙化对鉴别甲状腺结节良恶性的临床意义.方法 选取2009年1月至2011年11月在天津人民医院就诊的812例甲状腺病患者,所有患者均进行甲状腺彩超检查,观察结节内有无钙化,并与病理结果对照分析.结果 96例结节内伴钙化,34例为良性结节,62例为恶性结节.良性结节钙化超声图像表现为弧形强回声带,后方伴声影,直径≥2.0 mm.恶性结节钙化超声图像表现为斑点状强回声,直径＜2.0 mm,后方声影可有可无.甲状腺恶性结节的总钙化率及微钙化率分别为83.78%、96.0%,粗钙化组中癌的发生率为30.43%.结论 甲状腺结节内微钙化是诊断甲状腺癌的特异性指标,其他每种钙化都有恶性风险,特别对粗钙化不能简单除外恶性可能.%Objective To evaluate the clinical significance of ultrasound detection of thyroid nodule calcification in differentiation benign and malignant thyroid carcinoma.Methods 812 patients with thyroid diseases from Tianjin People's hospital from Jan.2009 to Nov.2011 were selected,all of which were examined by preoperative ultrasonography, and nodules calcification was observed, and compared with pathological results analysis.Results There were 96 cases of nodules with calcification nodules,34 cases of benign nodules,62 cases of malignant nodules.The features of benign nodules of calcification sonographic were of strong echoes with the rear arc ,with acoustic shadowing,diameter≥2.0 mm.The features of malignant nodules of calcification of the ultrasound image were punctuate echoism,diameter of <2.0 mm,posterior acoustic shadowing not essential.Calcification rate and microcalcification rate of malignant thyroid nodules were 83.78% and 96.0% , cancer incidence of the coarse calcifications group was 30.43%.Conclusion Micro-calcification is a characteristic index for thyroid carcinoma,while other types of calcifications represents a risk of malignancy, especially for the coarse calcification,the possibility of malignancy should not be simply excluded.