徐伟山东省泰安市肿瘤防治院影像特检科，山东泰安　271000

滤泡型甲状腺乳头状癌与甲状腺腺瘤的超声表现对比研究

徐伟
山东省泰安市肿瘤防治院影像特检科，山东泰安271000

目的 分析比较甲状腺腺瘤和滤泡型甲状腺乳头状癌的超声图像。方法 分析滤泡型甲状腺乳头状癌和确诊为甲状腺腺瘤患者的超声声像图，比较图边界的特征、超声图的形态、内部回声的情况及甲状腺部位的血流情况，并进行对比分析。结果 滤泡型甲状腺乳头状癌超声图像和甲状腺腺瘤的超声图像比较，图像中形态呈规则形、边界清晰所占比例、纵横比≥1所占的比例、有声晕所占比例差异无统计学意义（P＞0.05），但滤泡型甲状腺乳头状癌中微钙化的比例、低等回音的比例、中等及中等以上血流比例分别为31.58%、73.68%、60.53%，甲状腺腺瘤中微钙化的比例、低等回声的比例、中等及中等以上血流比例分别为20.00%、35.00%、27.50%，滤泡型甲状腺乳头状癌组的比例明显高于甲状腺腺瘤组，组间差异具有统计学意义（P＜0.05）；通过多因素Logistic回归分析，微钙化、回声、血流是滤泡型甲状腺乳头状癌的独立风险因素；甲状腺腺瘤组的诊断符合率明显高于滤泡型甲状腺乳头状癌组，组间差异具有统计学意义（P＜0.05）。结论 滤泡型甲状腺乳头状癌与甲状腺腺瘤的超声图像的恶性和良性有很多相似的特征，在临床诊断中需注意有效鉴别。

滤泡型；甲状腺乳头状癌；甲状腺腺瘤；超声图像

［Abstract］Objective To analyze and compare the ultrasound images between thyroid adenoma and follicular papillary thyroid carcinoma.Methods Ultrasound images of the patients with follicular papillary thyroid carcinoma and thyroid adenoma were analyzed，characteristics of image border，shape of the image，internal echo and blood flow of the thyroid were compared，and comparative analysis was performed.Results Ultrasound image of follicular papillary thyroid carcinoma was compared with the image of thyroid adenoma.The proportion of regular shape and clear border，proportion of aspect ratio≥1 and proportion of halo were not significantly different（P＞0.05），but the proportion of micro-calcification，proportion of low echo，and proportion of middle or above blood flow in follicular papillary thyroid carcinoma were 31.58%，73.68%and 60.53%respectively，and the the proportion of micro-calcification，proportion of low echo，and proportion of middle or above blood flow in thyroid adenoma were 20.00%，35.00%and 27.50%respectively.The proportion in the follicular papillary thyroid carcinoma group was significantly higher than that in the thyroid adenoma group，and the differences between groups were statistically significant（P＜0.05）；through multivariate Logistic regression analysis，micro-calcification，echo and blood flow were independent risk factors for follicular papillary thyroid carcinoma；the diagnosis accordance rate in the thyroid adenoma group was significantly higher than that in the follicular papillary thyroid carcinoma group，and the differences between groups were statistically significant（P＜0.05）.Conclusion Ultrasound images of malignant and benign lesions of follicular papillary thyroid carcinoma and thyroid adenoma share many similar characteristics，which should be effective identified in clinical diagnosis.

［Key words］Follicular；Papillary thyroid carcinoma；Thyroid adenoma；Ultrasound images

甲状腺滤泡型乳头状癌（follicular variant of papillary thyroid carcinoma，FVPTC）是甲状腺恶性肿瘤的常见类型，其中包括15个癌症的亚型，FVPTC的经典的2个亚型是滤泡型甲状腺乳头状癌和乳头状癌［1］。……