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目的 :探讨桥本甲状腺炎(Hashimoto’s thyroiditis,HT)背景下甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)的超声表现特点。方法 :回顾87例HT患者共90个经手术病理证实的甲状腺微小结节,分析其超声表现特征,包括结节的内部结构、回声水平、纵横比、形态、边界、声晕、微钙化、血供模式及血供程度。采用χ2检验及Fisher确切概率法比较HT背景下PTMC与良性微小结节的超声特征差异。结果:90个甲状腺微小结节术后经病理证实,其中59个为PTMC,31个为良性结节。PTMC与甲状腺微小良性结节间的微钙化、血供模式及血供程度差异有统计学意义(P<0.05);而两者间的内部结构、回声水平、纵横比、形态、边界、声晕差异均无统计学意义(P>0.05)。结论:超声检查对HT背景下PTMC病灶具有一定诊断价值,结节内的微钙化和血流情况可能有助于PTMC与良性病灶间的鉴别诊断。
Objective: To investigate the ultrasonographic features of papillary thyroid microcarcinoma (PTMC) in the setting of Hashimoto’s thyroiditis (HT). Methods: Totally 90 thyroid nodules confirmed by surgery and pathology were retrospectively analyzed. The ultrasonographic features were analyzed including internal structure of nodules, echo level, aspect ratio, morphology, border, sound halo, microcalcification, blood For the model and degree of blood supply. The χ2 test and Fisher exact test were used to compare the difference of ultrasound features between PTMC and benign nodules in HT background. Results: Ninety thyroid microneedles were pathologically confirmed, of which 59 were PTMC and 31 were benign nodules. The microcalcifications, blood supply patterns and blood supply between PTMC and thyroid benign nodules were significantly different (P <0.05), while the internal structure, echo level, aspect ratio, morphology, boundary and sound halo There was no significant difference (P> 0.05). CONCLUSIONS: Ultrasonography is of diagnostic value for PTMC lesions in the HT context. The presence of micro-calcifications and blood flow in the nodules may contribute to the differential diagnosis between PTMC and benign lesions.