目的 探讨甲状腺良性囊性皱缩结节与甲状腺微小乳头状癌的超声表现差异,进一步明确诊断,避免不必要的活检。方法 16例单发的良性囊性皱缩结节,最初经超声或CT确定含大于50%的囊性成分,超声随访显示病变最大直径减少30%以上。经随访的良性囊性皱缩结节(皱缩组)与31例单发的手术证实的甲状腺微小乳头状癌(癌组)比较,分析其形态、边界、回声、钙化等超声征象。结果 鉴别皱缩组和癌组的超声特征包括：低回声晕环诊断价值最高,AUC为0.809,其次为内部等回声环、毛刺及形态,AUC均大于0.70,而纵横比大于1对于鉴别皱缩组和癌组无统计学意义(P=0.069)。结论 超声有助于鉴别甲状腺良性囊性皱缩结节和微小乳头状癌的诊断,二者的形态、内部等回声环、低回声晕环灵敏度高而特异度低,毛刺特异度高而灵敏度低,相互结合诊断可降低漏诊率、误诊率。熟悉甲状腺良性囊性皱缩结节的超声特征有助于减少不必要的穿刺活检。

Objective To evaluate the difference of ultrasonographic(US) manifestations between Shrinking Benign Cystic Nodules(SBCN) and papillary thyroid miccarcinomas(PTMC), so as to further clarify the diagnosis and to avoid unnecessary biopsy. Methods US findings in 16 patients, each with a single SBCN, were evaluated to determine if they showed 50% cystic content on initial US or CT and 30% decrease in maximum diameter on follow-up US. We compared findings of follow-up SBCN with those of 31 patients, each with a single surgically confirmed PTMC. US scans were analyzed for shape, margin, echogenicity, calcification. Results US features that differed between SBCNs and PTMCs were hypo-echoic halo with the highest diagnostic value (AUC=0.809), inner isoechoic rim (AUC=0.732), spiculated margins (AUC=0.727), and shape (AUC=0.716). However, the taller-than-wide had no statistical significance in distinguishing SBCNs from PTMCs(P=0.069).

内蒙古自治区自然科学基金No.2017MS(LH)0850和内蒙古自治区人民医院院内基金No.201548