甲状腺恶性结节被膜浸润的超声诊断与病理对照

穆靓，刘莉 * ，南淑良，韦爱华，梁亮，向红，郝睿

陕西省人民医院，陕西 西安，710068

浏览次数：203次 下载次数：306次

摘要：

目的 探讨常规超声成像技术对甲状腺恶性结节并被膜浸润的诊断价值。方法 观察甲状腺恶性结节并被膜浸润的超声二维及彩色多普勒超声表现，并与手术病理结果对照分析。结果 最终纳入研究 52例患者（54个结节），通过与病理比较，超声检查分析甲状腺恶性结节与被膜的邻接关系，甲状腺表面轮廓外凸征象、被膜回声中断及血管延伸结节外与被膜浸润相关。结论 超声检查对甲状腺恶性结节被膜浸润是一种有效的诊断方法，有助于术前评估。

关键词： 甲状腺恶性结节；被膜浸润；超声诊断；病理对照

中图分类号： R445.1；R581文献标志码：A文章编号：2096-1413(2018)07-0142-02

Comparison of ultrasonography and pathology in the diagnosis of thyroid
malignant nodules with capsular invasion


MU Liang,LIU Li * ,NAN Shu-liang,W EIAi-hua,LIANG Liang,XIANG Hong,HAO Rui
(ShaanxiProvincialPeople`sHospital,Xi`an 710068,China)



ABSTRACT: Objective To explore the diagnosis value of conventional ultra sonography imaging in thyroid malignant noduleswith capsularinvasion.  MethodsThe ultra sonographic feature soft hyroid malignant nodules with capsular invasion were contrastly analyzed with the result of pathology. Results The finalanalysis group consisted of 52 patients with 54 nodules ofpapillary thyroid carcinoma.Compared with pathology,the adjacent relationship of thyroid malignant nodules and capsular invasion was analyzed by ultrasonography.The normal contour bulging,loss ofthe echogenic capsule and vascularity extending beyond the capsule related to capsular invasion.Conclusion Ultrasonography shows important value in the diagnosis of thyroid malignant nodules with capsular invasion,and may help in surgical planning and treatment.                                                                                                     　                                                                                                                                                                              KEYWORDS: thyroid malignant nodule;capsular invasion; ultra sonography; pathological findings


参考文献：
[1]ITO Y,URUNO T,NAKANO K,etal.An observation trialwithoutsurgicaltreatmentin patientswith papillary microcarcinoma ofthe thyroid[J].Thyroid,2003,13(4):381-387.
[2] ORTIZ S,RODRIGUEZ JM ,SORIA T,et al.Extrathyroid spread inpapillary carcinoma ofthethyroid:clinicopathologicaland prognosticstudy[J].OtolaryngolHead Neck Surg,2001,124(3):261-265.
[3]YAMAMURA N,FUKUSHIMA S,NAKAO K,etal.Relation betweenultrasonographic and histologic findings oftrachealinvasion by differentiated thyroid cancer[J].W orld JSurg,2002,26(8):1071-1073.
[4]KW AK JY,KIM EK,YOUK JH,etal.Extrathyroid extension ofwell-differentiated papillary thyroid microcarcinoma on US[J].Thyroid,2008,18(6):609-614.
[5] 孟召伟 , 谭建 . 解读美国甲状腺协会 2009 年甲状腺结节和分化型甲状腺癌诊治指南 [J]. 国际内分泌代谢杂志 ,2010,30(5):349-352.
[6]CHUNG YS,KIM JY,BAE JS,etal.Laterallymph node metastasis inpapillary thyroid carcinoma:results oftherapeutic lymph node dissection[J].Thyroid,2009,19(3):241-246.
[7]ZHANG Y,ZHOU P,TIAN SM,etal.Usefulness ofcombined use ofcontrast-enhanced ultrasound and TI-RADS classification for thedifferentiation ofbenign from malignantlesionsofthyroid nodules[J].EurRadiol,2017,27(4):1527-1536.
[8]GW EON HM,SON EJ,YOUK JH,etal.Preoperative assessmentofextrathyroidalextension ofpapillary thyroid carcinoma:comparison of2- and 3-dimensionalsonography[J].J Ultrasound Med,2014,33(5):819-825.