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目的:探讨超声影像在原发性甲状腺鳞状细胞癌(PSCCT)中的临床诊断价值。方法:收集住院经组织病理学确诊的PSCCT患者6例,回顾性分析其临床一般资料及超声影像学资料。结果:6例PSCCT患者年龄(49-77)岁,平均年龄64岁,临床上均表现为甲状腺肿大,4例伴呼吸困难,3例伴吞咽困难,3例伴声音嘶哑。6例患者均死亡,术后生存4-13个月,平均术后生存期8.5个月。超声影像学特点:16例PSCCT病灶大小较大(最大直径3.0-5.1 cm),结节为形态不规则,且边界不清晰的实性混合性回声肿块,内部可见片状极低回声区。2例患者的肿块内部存在少许微量钙化,另外4例则无明显钙化表现;2结节突破甲状腺被膜3例,且与甲状腺周围组织分界不清晰;34例结节内部血流信号表现为少量,呈点线状分布,2例结节内部血流信号表现为中量;45例肿块可测得高阻力频谱(RI0.72-0.88);5 3例患者伴有颈部异常淋巴结。结论:PSCCT具有一定超声影像特点,与临床表现相结合有助于该病的鉴别诊断。
Objective: To investigate the clinical value of ultrasound in the diagnosis of primary thyroid squamous cell carcinoma (PSCCT). Methods: Six patients with PSCCT diagnosed by histopathology were collected and retrospectively analyzed the clinical data and ultrasound imaging data. Results: The age of patients with PSCCT in six cases (49-77) years old, average age was 64 years old. The clinical manifestations were goiter, 4 cases of dyspnea, 3 cases of dysphagia and 3 cases of hoarseness with sound. All 6 patients died and survived 4-13 months postoperatively, with an average postoperative survival of 8.5 months. Ultrasound imaging features: 16 cases of PSCCT lesions larger size (maximum diameter of 3.0-5.1 cm), nodules for the irregular shape, and the boundary is not clear solid mixed echo mass, can be seen inside the sheet of very low echo area. There were a few microcalcifications in the mass in 2 patients and no obvious calcification in the other 4 patients. 3 nodules broke thyroid gland in 3 patients and the border between thyroid gland and thyroid gland was unclear. The internal blood flow signals of 34 nodules showed a small amount, The distribution of blood flow in two nodules was medium; the high resistance spectrum (RI0.72-0.88) was measured in 45 cases, and the neck was abnormal in 53 cases. Conclusion: PSCCT has a certain ultrasonic imaging characteristics, combined with clinical manifestations contribute to the differential diagnosis of the disease.