超声对甲状腺结节钙化的类型及其与甲状腺癌关系探讨

摘要

目的：探讨甲状腺结节钙化的不同分型及其与甲状腺癌的关系。方法经手术的523例甲状腺结节患者（586个结节）的病理结果与其术前超声检查甲状腺结节钙化的不同类型进行回顾性对照分析。结果586个结节中恶性结节227个（38.7%），良性结节359个（61.4%）；有钙化结节203个，良、恶性结节中钙化检出率分别是17.3%（62/359）、62.1%（141/227）。203个钙化结节中，单钙化和多钙化的恶性发生率分别52.4%（22/42）、73.9%（119/161）；微钙化、微钙化和粗钙化共存、不规则粗钙化、规则粗钙化的恶性发生率依次为：94.3%（83/88）、86.3%（44/51）、55%（11/20）、6.8%（3/44）；中央型钙化、混合型钙化、边缘型钙化、孤立型钙化的恶性发生率依次为：93.4%（85/91）、81.2%（52/64）、8.7%（4/46）、0（0/2）。结论合理的钙化分型在鉴别甲状腺结节的良恶性诊断中有重要意义，多个微钙化或微粗钙化共存呈中央型或混合型分布是诊断甲状腺癌的超声特征。%Objective To investigate the relationship of thyroid nodules calcification of different classification with thyroid cancer. Methods Five hundred and twenty-three patients with 586 thyroid nodules undergone thyroidectomy were analyzed retrospectively. Results Among 586 thyroid nodules, there were 227 malignant nodules and 359 benign nodules, including 203 calci-fication nodules, benign and malignant nodules of calcification detection rate was 17.3%(62/359), 62.1%(141/227). Among 203 calcification nodules, single calcification and multiple calcification of malignant occurrence rate was 52.4%(22/24), 73.9%(119/161); Microcalcification, coarse calcification, microcalcification and coarse calcification coexistence,irregular coarse calcification and rules coarse calcification of malignant occurrence rate was 94.3%(83/88), 86.3%(44/51), 55%(11/20), 6.8%(3/44); Central calcification, hybrid calcification, rim calci-fication and isolation calcification of malignant occurrence rate was 93.4%(85/91), 81.2%(52/64), 8.7%(4/46), 0 (0/2). Conclusion Reasonable calcification typing is important in diagnosising benign and malignant thyroid nodules. Multiple microcifications or microcalcification and coarse calcification coexistence is characteristic of ultrasound diagnosis of thyroid cancer.