杨 琛 YANG Chen 冯 娜 FENG Na王一凡 WANG Yifan王立平 WANG Liping彭婵娟 PENG Chanjuan

作者单位浙江省肿瘤医院超声科 浙江杭州 310022

超声钙化征象对桥本甲状腺炎背景下甲状腺乳头状癌的诊断价值

杨 琛 YANG Chen 冯 娜 FENG Na王一凡 WANG Yifan王立平 WANG Liping彭婵娟 PENG Chanjuan

作者单位
浙江省肿瘤医院超声科 浙江杭州 310022

Department of Ultrasound， Zhejiang Cancer Hospital， Hangzhou， Hangzhou 310022，China

Address Correspondence to: YANG Chen E-mail: carriey918@sina.com

浙江省医药卫生科技计划（2015KYB057）。

R736.1；R730.41

中国医学影像学杂志

2016年 第24卷 第6期：419-422

Chinese Journal of Medical Imaging 2016 Volume 24 （6）: 419-422

目的 探讨超声及其钙化特征对桥本甲状腺炎（HT）背景下甲状腺乳头状癌的诊断价值。资料与方法 回顾性分析885例经病理诊断的甲状腺结节的超声资料，其中伴发HT患者178例，非HT患者707例。结合病理结果，比较超声及其钙化征象对两者的诊断价值。结果 HT组超声诊断甲状腺结节良恶性准确率为76.40%，非HT组诊断准确率为80.76%，差异无统计学意义（P＞0.05）。HT组和非HT组恶性结节的微钙化率分别为50.77%、49.37%，HT组和非HT组恶性结节的粗钙化率分别为6.15%、12.55%，两组间恶性结节微钙化率及粗钙化率差异均无统计学意义（P＞0.05）。HT组与非HT组良性结节中微钙化率、粗钙化率差异无统计学意义（P＞0.05）。HT组伴微钙化恶性结节比例明显高于良性结节（50.77%比12.39%，χ2=31.279，P＜0.001）；非HT组中伴微钙化恶性结节的比例也明显高于良性结节（49.37% 比19.23%，χ2=69.220，P＜0.001）。HT组恶性结节伴粗钙化比例为6.15%，而良性结节伴粗钙化的比例为11.50%，差异无统计学意义（P＞0.05）。非HT组的恶性结节粗钙化比例为12.55%，明显高于良性结节的粗钙化比例6.62%（χ2=7.053，P＜0.01）。结论 HT背景对于超声诊断甲状腺结节的性质无显著影响。

甲状腺肿瘤；桥本病；超声检查；钙质沉着症；病理学，外科；诊断，鉴别

【Abstract】Purpose To investigate the value of ultrasonographic calcifcation in diagnosis of papillary thyroid carcinoma with hashimoto's thyroiditis （HT）. Materials and Methods 885 patients of thyroid nodule （178 HT cases and 707 non-HT cases） were selected in this study. Based on the results of postoperative pathology， the different manifestations of ultrasonographic calcifcation between two groups were compared. Results There was no significant difference in accuracy rate of ultrasonogrphic diagnosis between two groups （76.40% vs. 80.76%， P＞0.05）. There was no signifcant difference in the percentages of micro-calcification and percentages of macro-calcification in cancerous between two groups （50.77% vs. 49.37%； 6.15% vs. 12.55%， P＞0.05）. Also， the percentages of microcalcifcation and macro-calcifcation in non-cancerous nodules between two groups had no statistically different （P＞0.05）. Compared with non-cancerous nodules in HT group， the micro-calcifcation proportion was signifcantly higher in cancerous nodules （50.77% vs. 12.39%， χ2=31.279， P＜0.001）， while compared with non-cancerous nodules in non-HT group， the micro-calcifcation proportion was also signifcantly higher in cancerous nodules （49.37% vs. 19.23%， χ2=69.220， P＜0.001）. There was no significant difference in the macro-calcifcations proportion between cancerous and non-cancerous nodules in HT group （6.15% vs. 11.50%， P＞0.05）. In the non-HT group， the macro-calcifcation proportion in cancerous nodules was 12.55%， which was higher than that in non-cancerous nodules 6.62% （χ2=7.053， P＜0.01）. Conclusion There is no statistically signifcant effect on the ultrasonographic diagnosis of thyroid nodule with HT.

【Key words】Thyroid neoplasms； Hashimoto disease； Ultrasonography； Calcinosis；Pathology， surgical； Diagnosis， differential

桥本甲状腺炎（hashimoto's thyroiditis，HT）又称慢性淋巴细胞性甲状腺炎，是一种自身免疫性疾病，病程漫长。……