55例桥本甲状腺炎合并结节的超声声像图及误诊分析  

Analysis on Ultrasonic Diagnosis of Hashimoto's Thyroiditis with Nodular Lesions

作　　者：朴雪梅[1] 梁峰[1] 刘国华[1] 于泽兴 王湘竹[3] 

机构地区：[1]北京市平谷区医院超声科,北京101200 [2]北京市朝阳医院超声科,北京100020 [3]北京中医药大学超声科,北京100700

出　　处：《现代生物医学进展》2013年第18期3535-3537,共3页Progress in Modern Biomedicine

摘　　要：目的:对桥本甲状腺炎(HT)合并结节样病变的超声诊断以及误诊情况进行分析。方法:选取本院在2011年6月-2012年6月收治的55例桥本甲状腺炎合并单发和多发结节患者作为研究对象,全部患者均经过手术及病理学证实,对全部结节样病变的超声影像图进行分析,并对该病的诊断率提高的方式进行讨论。结果:在全部患者中,单个结节24例,合并乳头状癌为7例,合并滤泡性腺瘤为3例;多个结节为31例,合并乳头状癌为5例,合并滤泡性腺瘤为3例,合并结甲11例。其中,35例与病理相符,诊断准确率63.6%,误诊20例,有18例误诊为结节性甲状腺肿,2例为甲状腺癌,误诊率为36.4%。单纯性桥本甲状腺炎结节与甲状腺癌结节,在结节的形态、边界、内部伴有钙化的形态上以及血流信号的分布上有显著差异。结论:全面检查血清学的甲状腺抗体,并关注结节之外的腺体回声以及腺体供血的状况;应该高度注意结节是否出现形态不规则、伴有钙化灶以及边界模糊的特征,提示恶变的可能,给临床医生以最有价值的提示,全面提高超声的正确诊断率。Objective：To analyze the ultrasonic diagnosis and misdiagnosis causes of hashimoto＇s thyroiditis with nodular lesions.Methods：55 cases of hashimoto＇s thyroiditis patients complicated with single and multiple nodules from June 2011 to June 2012 in the hospital were selected as the object of study,all patients were confirmed by surgical pathology,and the way of the diagnosis were discussed.Results：The results showed that 24 cases were single nodule,7 cases of these were HT complicated with papillary thyroid cancer,3 cases were complicated with follicular adenoma;31 cases were multiple nodules,5 cases were complicated with papillary carcinoma and 3 cases were complicated with follicular adenoma,11 cases were complicated with nodular goiter.Among these cases,35 cases were consistent with pathology,the diagnostic accuracy rate was 63.6%.20 cases were misdiagnosed.18 of 20 cases were misdiagnosed as nodular goiter.The other 2 cases were misdiagnosed as papillary carcinoma.The misdiagnosis rate was 36.4%.Between Simple Hashimoto＇s thyroiditis nodule and thyroid cancer nodule,there were significant differences in the shape,border,calcification morphology and color flow signal distribution.Conclusion：Comprehensive examination of thyroid antibodies should be done,and consider external gland echo,thyroid blood supply and pay attention to the irregular nodules,with calcification and fuzzy boundary feature,suggest the possibility of malignant transformation,to provide the clinician valuable information,and comprehensively improve the correct diagnosis rate of ultrasound.

关 键 词：桥本氏甲状腺炎 甲状腺结节 超声 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]