目的研究高频彩色多普勒超声(高频彩超)在甲状腺癌和甲状腺腺瘤诊断和鉴别诊断中的临床应用价值.方法 对首都医科大学宣武医院2006年1月-2012年1月经手术病理证实的80例甲状腺癌和40例甲状腺腺瘤患者的高频彩超图像进行回顾性分析,比较二种疾病的声像特点、回声、钙化、血流特点等.结果 本组研究对象中80例甲状腺癌以乳头状癌和滤泡癌为主,高频彩超诊断准确率约为93.8%,其声像特点有:(1)甲状腺癌多数呈球形、类圆形或不规则形;(2)甲状腺癌边缘不规则,多数有毛刺、蟹足样、声晕发生率较低;(3)甲状腺癌多数以实质性回声为主;(4)肿瘤内部常伴有不同程度的钙化;(5)甲状腺癌血供大多较丰富,血供以高阻力为特点.但是部分甲状腺癌病灶较小,尤其是直径在0.5cm以下的病灶,容易漏诊.结论 高频超声在甲状腺癌和甲状腺腺瘤的诊断和鉴别诊断中有较大的临床实用价值,值得进一步推广并应用于其他肿瘤.%Objective To investigate the clinical value of high resolution ultrasound in the diagnosis and differential diagnosis of thyroid carcinoma. Methods A total 80 thyroid carcinoma and 40 thyroid adenoma patients were demonstrated by operation pathology between January 2006 and January 2012 which were included into this study. All these high resolution ultrasound images were analyzed restrospetively. The image characteristics, echo , calcification and blood flow of the two diseases were compared. Results The pathology of most thyroid carcinoma patients is papillary and follicular carcinoma. The correct rate of high resolution ultrasound is about 93. 8%. The characteristics of high resolution ultrasound of thyroid carcinoma included( 1 )the shapes of tumors were round and irregular,( 2 )the edge of tumors were irregular,most tumors with spurs, similar with crab foot,and rare halo,( 3 )most thyroid carcinoma were substantially hypoechogenic,( 4 )most thyroid carcinoma had calcification, ( 5 )most thyroid carcinoma had blood flow. However,the diameter of some thyroid carcinoma is small,especially lesions smaller than 0.5 centimeter, which is easily misdiagnosed. Conclusion The high resolution ultrasound showed high and clinical value in the diagnosis and differential diagnosis of thyroid carcinoma. This technology can be used in the diagnosis of other tumors,such as breast tumors.
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