US features of thyroid malignancy: Pearls and pitfalls
US features of thyroid malignancy: Pearls and pitfalls
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DOI：
10.1148/rg.273065038
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发表时间：
2007-05-01
期刊：
影响因子：
5.5
通讯作者：
Farrell, Stephen
中科院分区：
文献类型：
--
作者：
Hoang, Jenny K.;Lee, Wai Kit;Farrell, Stephen
甲状腺结节很常见，高达 50% 的成年人会出现甲状腺结节；然而，只有不到 7% 的甲状腺结节是恶性的。高分辨率超声检查 (US) 通常用于评估甲状腺，但 US 经常被误解为无助于识别区分良性结节和恶性结节的特征。微钙化是甲状腺恶性肿瘤最具体的美国发现之一。其他有用的超声特征包括明显的低回声、边缘不规则以及结节周围没有低回声晕。淋巴结肿大和邻近结构的局部侵犯是甲状腺恶性肿瘤的高度特异性特征，但不太常见。结节的数量、大小和间隔生长是非特异性特征。当偶然发现结节或存在多个结节时，可疑的超声特征可能有助于选择患者进行细针抽吸活检。可能导致无法识别恶性肿瘤的常见解释陷阱包括将囊性或钙化的淋巴结转移误认为是多结节性甲状腺中的结节，将弥漫性浸润性甲状腺癌和多灶性癌误认为是良性疾病，以及未能识别乳头状甲状腺癌中的微钙化。 (C) 北美放射学会，2007 年。
Thyroid nodules are common and occur in up to 50% of the adult population; however, less than 7% of thyroid nodules are malignant. High-resolution ultrasonography ( US) is commonly used to evaluate the thyroid gland, but US is frequently misperceived as unhelpful for identifying features that distinguish benign from malignant nodules. Microcalcifications are one of the most specific US findings of a thyroid malignancy. Other useful US features include a marked hypoechogenicity, irregular margins, and the absence of a hypoechoic halo around the nodule. Lymphadenopathy and local invasion of adjacent structures are highly specific features of thyroid malignancy but are less commonly seen. The number, size, and interval growth of nodules are nonspecific characteristics. Suspicious US features may be useful for selecting patients for fine-needle aspiration biopsy when incidental nodules are discovered and when multiple nodules are present. Common interpretative pitfalls that may lead to failure to recognize a malignancy include mistaking cystic or calcified nodal metastases for nodules in a multinodular thyroid, mistaking diffusely infiltrative thyroid carcinomas and multifocal carcinomas for benign disease, and failing to recognize microcalcifications in papillary thyroid cancer. (C) RSNA, 2007.