高频超声在甲状腺微小癌侵袭中的诊断价值

目的评价高频超声在甲状腺微小乳头状癌是否侵袭中的诊断价值。方法回顾性分析2015年12月—2019年11月的165例我院经病理证实甲状腺微小乳头状癌超声资料,分析结节内部回声特点、纵横比、钙化、边界、临近甲状腺包膜是否完整等超声特征,并记录有无提示颈部区域淋巴结转移。结果165例患者中,淋巴结转移34例,患者性别、年龄、甲状腺包膜、结节周围声晕4项临床超声特征差异具有统计学意义(P<0.05);根据多因素二分类回归分析,各因素对淋巴结转移相关因素影响由大到小依次为结节声晕>甲状腺包膜>位置>年龄,不均匀声晕淋巴结转移率可达36.7%。结论病灶发生年龄、位置、临近甲状腺包膜完整程度、结节周围声晕情况与甲状腺微小乳头状癌发生率淋巴结转移有一定相关性,检查时应着重扫查颈部尤其中央区淋巴结,从而提高诊断的准确性。

The Diagnostic Value of High Frequency Ultrasound in Determining the Invasion of Papillary Thyroid Microcarcinoma

Objective To evaluate the diagnostic value of highfrequency ultrasound in papillary thyroid microcarcinoma. Methods Retrospective analysis was performed on the ultrasonic data of 165 cases of papillary thyroid microcarcinoma confirmed by pathology in our hospital from December 2015 to November 2019. To evaluate the ultrasonic characteristics such as the internal echo of the nodules, aspect ratio, calcification type, boundary edge, and the integrity of the adjacent thyroid capsule, and the presence of cervical lymph node metastasis was recorded in the ultrasound report. Results Among the 165 patients with PTMC, there were 34 patients in the metastasis group. The single-factor differences among the four clinical ultrasonic characteristics of patients including gender, age, thyroid capsule and tuberous acoustic halo were statistically significant(P < 0.05).According to the regression analysis of multi-factor dichotomy, the influence of each factor on the related factors of lymph node metastasis is from the largest to the smallest, and the influence of each factor on the related factors of lymph node metastasis is from the largest to the smallest. The rate of lymph node metastasis in heterogeneous acoustic halos was up to 36.7%. Conclusion The incidence of papillary thyroid microcarcinoma with lymph node metastasis was correlated with the age, location, degree of thyroid capsule integrity, and the acoustic halo around the nodules. The examination should focus on the observation and carefully scan the neck especially the central area of the lymph nodes, so as to improve the accuracy of the diagnosis.