摘要
【目的】探讨桥本甲状腺炎（HT）合并结节样病变的超声声像特征、鉴别诊断及误诊原因。【方法】分析56例经手术病理证实的桥本甲状腺炎合并结节样病变的超声声像特征。【结果】56例HT合并结节样病变中，病理证实：32例单纯HT结节（单发或多发），15例HT合并乳头状癌，7例HT合并滤泡性腺瘤，2例HT合并结节性甲状腺肿。超声检查诊断单纯HT结节（单发或多发）26例，甲状腺癌7例，腺瘤5例，结节性甲状腺肿2例，与病理相符，诊断准确率71．4％（40／56）。误诊16例，其中5例单纯HT结节、7例甲状腺癌及2例腺瘤误诊为结节性甲状腺肿，2例单纯HT结节误诊为腺瘤，误诊率为28．6％。甲状腺癌与单纯性HT结节，在结节形态不规则、边界不清晰、内部伴钙化声像表现上有显著差异。【结论】对HT甲状腺结节的超声诊断应以结节外腺体回声情况及腺体血供情况并结合血清学甲状腺抗体的检测进行全面分析和判断；对于结节形态不规则、边界不清晰、伴有钙化灶者要警惕．合并有恶变的可能。
[Objective]To explore the ultrasound features, differential diagnosis and misdiagnosis causes of hashimoto＇s thyroiditis（HT） with nodular lesions. [Methods] Ultrasound features of 56 HT patients complicated with nodular lesion confirmed by surgical pathology were analyzed. [Results] Pathological examination showed that 32 cases of all 56 cases were single or multiple HT nodule, and 15 cases were HT complicated with papillary thyroid cancer, and 7 cases were HT complicated with follicular adenoma, and 2 cases were HT complicated with nodular goiter. Ultrasound examination showed that 26 cases were single or multiple HT nodule, and 7 cases were thyroid cancer, and 5 cases were thyroid adenoma, and 2 cases were nodular goiter. The ultrasound diagnosis was consistent with pathology, and the diagnostic accuracy was 71.4%. Among 16 cases misdiagnosed, 5 cases of simple HT nodule, 7 cases of thyroid cancer and 2 cases of thyroid adenoma were misdiagnosed as nodular goiter. Ultrasound features such as irregular figure, unclear border and calcification showed significant difference between thyroid cancer and simple HT nodule, [Conclusion]The ultrasound diagnosis of HT with nodular lesion should comprehensively consider external gland echo, thyroid blood supply and the detection of thyroid antibodies for complete analysis and judgment. For patients with irregular nodule, unclear border and calcification, the complicating cancer should be cautioned.
出处
《医学临床研究》
CAS
2012年第3期478-480,共3页
Journal of Clinical Research
