规范与共识
ENGLISH ABSTRACT
甲状腺结节影像检查流程专家共识
中华医学会放射学分会头颈学组
作者及单位信息
·
DOI: 10.3760/cma.j.issn.1005-1201.2016.12.003
Imaging flow consensus of thyroid nodules
Chinese Medical Association Chinese Society of Radiology Head and Neck Group
Authors Info & Affiliations
Chinese Medical Association Chinese Society of Radiology Head and Neck Group
·
DOI: 10.3760/cma.j.issn.1005-1201.2016.12.003
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摘要

甲状腺结节临床多见,4%人群体检可触及结节,50%人群行超声检查可发现结节,50%尸检能够发现结节,其中5%的甲状腺结节为恶性 [ 1 , 2 , 3 , 4 ] 。甲状腺恶性肿瘤包括原发性甲状腺癌、转移癌和肉瘤,其中绝大多数为原发性甲状腺癌,日常生活及工作中提及的甲状腺恶性结节多指原发性甲状腺癌。依据组织构成,原发性甲状腺癌分为乳头状甲状腺癌(papillary thyroid carcinoma,PTC)、滤泡细胞癌、髓样癌及未分化癌,其中PTC占80%~88% [ 5 , 6 ] 。经外科手术和 131I治疗,甲状腺癌的5年生存率达97% [ 7 ] ,10年生存率达96% [ 8 ] ,对于低危的PTC,5年和10年生存率可达近100% [ 9 , 10 ] 。30%~90%的PTC在确诊时伴有颈部淋巴结转移 [ 11 ] ,淋巴结转移是局部复发的重要风险因子,其危害较原发灶更为严重。因此,依据临床资料及影像特征,尽早将少数原发性甲状腺癌从众多的良性结节中鉴别出来,并对其进行分期、预测侵袭性和随访,对制定治疗方案和改善预后均具有重大意义。目前,针对甲状腺结节主要的影像检查方法包括超声、超声引导下细针穿刺细胞学检查(fine needle aspiration cytology,FNAC)、CT、MRI和核素检查等,这些检查方法各有优势及不足,制定合理的影像检查流程至关重要。为此,中华医学会放射学分会头颈学组和《中华放射学杂志》编辑部组织影像科、核医学科、超声科、内科和外科相关专家,经过多次讨论,形成了此版甲状腺结节影像检查流程专家共识供广大临床和影像医师参考,今后还将根据大家的反馈不断完善和改进。

引用本文

中华医学会放射学分会头颈学组. 甲状腺结节影像检查流程专家共识[J]. 中华放射学杂志,2016,50(12):911-915.

DOI:10.3760/cma.j.issn.1005-1201.2016.12.003

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甲状腺结节临床多见,4%人群体检可触及结节,50%人群行超声检查可发现结节,50%尸检能够发现结节,其中5%的甲状腺结节为恶性 [ 1 , 2 , 3 , 4 ]。甲状腺恶性肿瘤包括原发性甲状腺癌、转移癌和肉瘤,其中绝大多数为原发性甲状腺癌,日常生活及工作中提及的甲状腺恶性结节多指原发性甲状腺癌。依据组织构成,原发性甲状腺癌分为乳头状甲状腺癌(papillary thyroid carcinoma,PTC)、滤泡细胞癌、髓样癌及未分化癌,其中PTC占80%~88% [ 5 , 6 ]。经外科手术和 131I治疗,甲状腺癌的5年生存率达97% [ 7 ],10年生存率达96% [ 8 ],对于低危的PTC,5年和10年生存率可达近100% [ 9 , 10 ]。30%~90%的PTC在确诊时伴有颈部淋巴结转移 [ 11 ],淋巴结转移是局部复发的重要风险因子,其危害较原发灶更为严重。因此,依据临床资料及影像特征,尽早将少数原发性甲状腺癌从众多的良性结节中鉴别出来,并对其进行分期、预测侵袭性和随访,对制定治疗方案和改善预后均具有重大意义。目前,针对甲状腺结节主要的影像检查方法包括超声、超声引导下细针穿刺细胞学检查(fine needle aspiration cytology,FNAC)、CT、MRI和核素检查等,这些检查方法各有优势及不足,制定合理的影像检查流程至关重要。为此,中华医学会放射学分会头颈学组和《中华放射学杂志》编辑部组织影像科、核医学科、超声科、内科和外科相关专家,经过多次讨论,形成了此版甲状腺结节影像检查流程专家共识供广大临床和影像医师参考,今后还将根据大家的反馈不断完善和改进。
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备注信息
A
陶晓峰,200011上海交通大学医学院附属第九人民医院放射科,Email: mocdef.3ab61.pivgnefoaixoat.rjc
B
鲜军舫,100730首都医科大学附属北京同仁医院放射科,Email: mocdef.3ab61.pivgnafnujnaix.rjc
C

执笔者:韩志江,310006 杭州市第一人民医院放射科,Email:hzjsyy@126.com;吴颖为,200011上海交通大学医学院附属第九人民医院放射科,Email:wuyw0103@hotmail.com

D
冯晓源、刘士远、王培军、顾雅佳、苏丹柯、徐辉雄、罗葆明、熊屏、罗渝昆、罗全勇、吕中伟、马玉波、范先群、周慧芳、朱永学、张陈平、罗定存、宁光、顾岩、李江、王萍、高宏教授的指导和帮助
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