摘要
目的分析不同大小、位置甲状腺微小乳头状癌(PTMC)的声像图特征,探讨纵横比(A/T)与甲状腺被膜侵犯的关系。方法收集经病理证实的407例PTMC患者(495个结节),分为最大径≤0.5cm组和最大径>0.5cm组,观察结节的声像学特征,并分析A/T与被膜侵犯的关系。结果 2组间血流类型、病灶与被膜关系、钙化、形态、A/T差异均有统计学意义(P均<0.05)。与被膜关系密切且A/T≥1的结节中,最大径>0.5cm组被膜侵犯率(117/185,63.24%)高于最大径≤0.5cm组(25/61,40.98%,P<0.01)。以A/T≥1判断最大径≤0.5cm组和最大径>0.5cm组与被膜关系密切的结节出现被膜侵犯的敏感度为89.29%、73.58%,特异度为29.41%、37.61%;紧邻被膜和突破被膜的结节中,A/T≥1与A/T<1的结节间被膜侵犯率差异均无统计学意义(P均>0.05);接触被膜的结节中,A/T≥1的结节被膜侵犯率(46/67,68.66%)高于A/T<1的结节(10/27,37.04%)。以A/T≥1判断接触被膜的结节出现被膜侵犯的敏感度为82.14%,特异度为44.74%。结论超声可观察PTMC大小、A/T及病灶与被膜的关系,为判断PTMC是否出现被膜侵犯提供诊断依据。
Objective To analyze the ultrasonic features of papillary thyroid microcarcinoma（PTMC）with different size and location,and to investigate the relationship of aspect transverse ratio（A/T）and capsule invasion in PTMC.Methods Totally 407 patients of PTMC with 495 nodules confirmed by pathology were enrolled.The nodules were divided into largest diameter≤0.5 cm group and largest diameter0.5 cm group.The ultrasonic signs of nodules were observed,and the relationship between A/T and thyroid capsule invasion was analyzed.Results The differences of blood type,relationship with capsule,calcification,morphology and A/T were statistically significant between the two groups（all P〈0.05）.In nodules closed to capsule and A/T≥1,the rate of capsule invasion in diameter0.5 cm group（117/185,63.24%）was higher than that in diameter≤0.5 cm group（25/61,40.98%,P〈0.01）.Taking A/T≥1 as the standard,the sensitivity of A/T in estimating capsule invasion of nodules closed to capsule in diameter≤0.5 cm group and diameter0.5 cm group was 89.29% and 73.58%,the specificity was 29.41% and 37.61%,respectively.In nodules adjacent to capsule and broken through capsule,the difference of capsule invasion rate was not significant between nodules with A/T≥1 and A/T1（both P〈0.05）.In nodules that contact capsule,the capsule invasion rate of A/T≥1 nodules（46/67,68.66%）was higher than that of A/T1（10/27,37.04%）.Taking A/T≥1 as the standard,the sensitivity of A/T in estimating capsule invasion of nodules touched capsule was 82.14%,and the specificity was 44.74%.Conclusion Ultrasonography can show the size,A/T and relationship with capsule in PTMC,which can provide diagnostic evidences in judging capsule invasion of PTMC.
作者
郭晶晶
薛恩生
俞丽云
梁荣喜
杨嘉嘉
陈舜
GUO Jingjing;XUE Ensheng;YU Liyun;LIANG Rongxi;YANG Jiajia;CHEN Shun(Department of Ultrasound,Union Hospital of Fujian Medical University,FujianProvincial Institute of Ultrasonic Medicine,Fuzhou 350001,China)
出处
《中国医学影像技术》
CSCD
北大核心
2018年第6期850-854,共5页
Chinese Journal of Medical Imaging Technology
基金
福建医科大学苗圃基金(2015MP013)
关键词
甲状腺肿瘤
超声检查
纵横比
被膜
Thyroid neoplasms
Ultrasonography
Aspect transverse ratio
Capsule
