慢性淋巴细胞性甲状腺炎声像图表现及其结节的鉴别  

Sonographic characteristics of chronic lymphocytic thyroiditis with or without nodules

作　　者：原韶玲[1] 王寅[1] 张洪英 卢伟[1] 赵培鹏[1] 

机构地区：[1]山西省肿瘤医院超声科,太原030013 [2]山西三维职工医院B超室

出　　处：《肿瘤研究与临床》2009年第2期111-113,116,共4页Cancer Research and Clinic

摘　　要：目的探讨慢性淋巴细胞性甲状腺炎（CTL）声像图表现及其结节的鉴别。方法对107例CTL患者应用常规超声二维高频探头检测甲状腺大小、回声、内部结节及其钙化、液化情况，部分病例进行彩色多普勒血流及血清甲状腺内分泌水平测定，并与手术病理结果对照。结果单纯CTL57例中，回声弥漫减低型CTL14例（24．6％），结节型CTL43例（75．4％），其中弥漫小结节型16例（37．2％），散在结节型27例（62．8％）。病理表现以间质内淋巴细胞和浆细胞浸润为主，甲状腺滤泡萎缩纤维化，形成境界清楚的结节。合并结节性甲状腺肿40例（37．4％），合并腺瘤4例（3．7％），合并甲状腺癌4例（3．7％），合并淋巴瘤1例（1％），合并甲状腺功能亢进1例（1％）。本组74例彩色多普勒血流显示：血流0-Ⅰ级34例，Ⅱ级38例，Ⅲ级2例。38例（100％）Anti-Tpo、Anti-TG增高，26例（68．4％）TSH升高。结论CTL声像图表现较为复杂，合并疾病多见。CTL结节与其伴随甲状腺疾病的结节，声像图上有其特征性表现，超声鉴别CTL及其伴随结节的性质可以为临床治疗CTL提供有力依据，避免不必要的手术。Objective To study and distinguish the sonographic characteristics of chronic lymphocytic thyroiditis （CTL） and its nodules. Methods Ultrasonographic characteristics of 107 patients with histologically confirmed CTL was observed with a 7.5-12 MHz transducer and confirmed with the operation and pathology. Seventy four cases of CTL were examined by color Doppler flow image （CDFI）, serum thyroid hormone levels were determined in 38 cases of CTL. Results In 57 cases of CTL, the pattern of diffuse low echoes was found in 14 cases （24.6 %）, and nodulose pattern in 43 cases （75.4 %） in which diffuse numerous hypoecoic microdules in 16 （37.2%）, and sporadic small nodules in 27 （62.8 %）. All cases showed degeneration and disappearance of thyroid follicles, lymph cells invasion in varying degrees on pathology. Nodular goiter was commonly detected in 40 cases CTL （37.4 % ）, adenoma in 4 cases （3.7 % ）, hyperthyroidism in one case, non-Hodgkin lymphoma in one case, thyroid carcinoma in 4 cases （3.7 %）. Color dopple flow imaging showed in 74 cases, 0-Ⅰ 34 cases, Ⅱ 38 cases, Ⅲ 2 cases. The increased flow were observed in 38 cases in both Anti-Tpo and Anti-TG, and in 26 cases in TSH. Conclusion Uhrasonography is complex in CTL, with more complications. Uhrasonography are distinguished between the nodule of CTL and the nodule in the other thyroid diseases. Ultrasonography could help to avoid unnecessary surgical intervention, and provide strong evidence for CTL and its complication in clinic treatment.

关 键 词：甲状腺炎 自身免疫性 超声检查 结节 

分 类 号：R44[医药卫生—诊断学] R5[医药卫生—临床医学]