甲状腺微小癌病灶钙化超声表现及其诊断意义

摘要

Objective To explore the ultrasonics finding and diagnosis significance of calcification in the thyroid microcarcinoma (TMC). Methods The calcification and related clinical data in 68 cases of TMC and 60 cases of thyroid benign diseases were retrospectively analyzed. Results Calcification rate in 68 cases of TMC and in 60 cases of thyroid benign diseases were detected by ultrasound accounted for 67.6%(46/68)and 33.3%(20/60) respectively (P<0.01);the pathological lesion calcification rate was 72.1% (49/68) and 35% (21/60), respectively(P<0.01). Micro-calcifications in benign or malignant calcification nodules accounted for 20.8%(10/48) and 79.2%(21/60),respectively (P<0.01). The 49 malignant cases were detected among 70 cases of calcifications (70.0%),calcification in papillary carcinoma accounted for 75.0%(51/68) among TMC,and the positive rate of detected calcifications in TMC was 55.9%(38/68),and the positive rate of micro-calcification in papillary carcinoma was 72.5%(37/51). Conclusion Microcalcification is the highest specific feature to diagnose TMC, while most TMC are papillary carcinoma,so it just has most important significance to diagnose TMC by ultrasonic inspection.%目的：探讨钙化在甲状腺微小癌（thyroid microcarcinoma，TMC）中的表达及超声诊断意义。方法回顾分析68例TMC和60例甲状腺良性疾病的病灶钙化情况和相关资料。结果 TMC和甲状腺良性疾病病灶钙化超声检出率分别为67．6％和33．3％（P＜0．01）；病理检查结果病灶钙化率分别为72．1％和35．0％（P＜0．01）。微钙化在良、恶性钙化结节中所占比例各为20．8％和79．2％（P＜0．01）。结节钙化中有70．0％为恶性，无钙化结节中32．8％为恶性（P＜0．01）。TMC病灶微钙化发生率为55．9％，乳头状癌微钙化率为72．5％。女性及年龄＜45岁TMC患者的病灶钙化率较良性疾病均明显为高，（P＜0．01）。结论 TMC绝大多数为乳头状癌，微钙化是TMC特异性最高的超声表现特征，对TMC的诊断有十分重要意义。