超声对甲状腺癌漏误诊原因的探讨  

Analysis on the Reasons of Mistaken and Missed Diagnosis of Ultrasound in Thyroid Cancer

作　　者：李泉水[1] 邓水平[1] 陈胜华[1] 邹霞[1] 熊华花[1] 刘倩[1] 王晶[1] 

机构地区：[1]深圳大学第一附属医院(深圳市第二人民医院)超声科,广东省深圳市518035

出　　处：《中国超声医学杂志》2012年第10期890-892,共3页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市医学重点学科建设经费(No.2005CD6)

摘　　要：目的探讨甲状腺癌的常见漏误诊原因,以提高甲状腺癌的超声诊断水平。方法回顾性分析经病理证实的140例甲状腺癌声像图特征,分析漏误诊原因。结果 146个恶性结节误诊37个,漏诊1个,误诊结节多表现为边界清晰(59.46%),有晕征(32.43%),少部分可见钙化(27.03%),误诊组与正确提示组在边界、钙化、晕征、结节内呈无回声区等方面有显著性差异(P<0.05)。<1 cm的结节在纵横比、微钙化、合并多发结节与正确提示组有显著性差异(P<0.05)。结论恶性结节超声表现边界清晰,有晕征,内部有无回声区等良性病变的特征时容易误诊,微小癌无微钙化、纵横比<1cm、合并多发良性结节时易被漏误诊。Objective To evaluate the reasons of mistaken and missed diagnosis of thyroid cancer, and to improve diagnosis accuracy of ultrasound in thyroid cancer. Methods We retrospectively analyzed the reasons of mistaken and missed diagnosis of 140 cases of thyroid cancer which confirmed by pathology. Results All recorded 140 cases of thy- roid cancer diagnosed have 146 malignant nodules. 37 nodules were misdiagnosed, 1 nodules was missed. A part of misdiagnosed nodules showed well-defined （ 59.46 % ）, halo sign （ 32.43 % ）, small part with calicifications （ 27.03%）. There were significant different between misdiagnosed group and correct group in boundary, calicifieations, halo sign and cystic component （P〈0.05）. There were significant different between misdiagnosed group and correct group in L/T, ealicifications and accompaning by multiple benign nodules to diameter 〈1 cm （P〈0. 05）. Conclusions Malig- nant nodules accompanied by features of benign nodules with a well-defined, halo sign and/or cystic component were easily misdiagnosed. Thyroid caner diameter 〈1 cm without microealicifications, L/T〈1 and accompaning by multi- ple benign nodules were easily misdiagnosed or missed.

关 键 词：甲状腺癌 超声 误诊 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]