甲状腺乳头状癌颈部淋巴结清扫术后颈部创伤性神经瘤的超声表现  

Ultrasonographic manifestations of traumatic neuromas after neck dissection in papillary thyroid carcinoma

作　　者：彭艳[1] 周伟[1] 詹维伟[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院超声科,上海200025

出　　处：《中国医学影像技术》2017年第6期859-862,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨甲状腺乳头状癌(PTC)颈部淋巴结清扫术后颈部创伤性神经瘤的声像图特征。方法回顾性分析21例PTC颈部淋巴结清扫术后颈部创伤性神经瘤患者的资料,观察其超声表现,包括病灶的数目、位置、大小、形态、边界、内部回声、是否与神经相连及病灶内血供情况。结果 21例患者共26个病灶中,25个位于颈侧区,1个位于中央区。病灶横径(3.5±1.0)mm,纵径(9.1±2.9)mm。13个病灶呈椭圆形,另13个病灶呈圆形。13个病灶边界清晰,另13个病灶边界模糊。26个病灶均呈不均匀低回声,其中16个病灶内部可见高回声。20个病灶表现为明确与神经相连,余6个病灶与神经相连不明确。20个病灶内可探及少许点状血流信号,余6个病灶内无明显血流信号。超声引导下细针穿刺活检过程中21例患者均主诉针刺部位难以忍受的剧痛,当针尖移开后疼痛消失。结论 PTC颈部淋巴结清扫区域术后低回声病灶,且病灶两端呈现与神经纤维相连的典型声像图特征,同时结合穿刺时患者有剧烈疼痛的主诉,应考虑创伤性神经瘤的可能。Objective To investigate the ultrasonographic manifestations of traumatic neuroma after neck dissection in pa- pillary thyroid carcinoma （PTC）. Methods A retrospective analysis was performed in 21 patients with 26 lesions who un- derwent neck dissection. The ultrasonographic characteristics were reviewed, including numbers, location, size, shape, margin, echogenicity, with or without direct continuity to the nerve fiber, the presence of internal hyperechogenicity and blood supply. Results Among the 26 lesions of 21 patients, 25 lesions were in the lateral cervical area while the other one was in the central cervical area. The mean shortest diameter of the lesions was （3.5 ±1.0）mm and that of longest diameter was （9.1±2.9）mm. Totally 13 lesions were oval in shape and the other 13 were round. The clear margin was found in 13 lesions and fuzzy margin was observed in another 13 lesions. All the lesions were heterogeneously hypoechoic. The pres- ence of internal hyperechoic areas were found in 16 lesions. The direct continuity with the nerve fiber was found in 20 le- sions, while the other 6 lesions were not continued to the nerve directly. Color Doppler flow imaging showed that 20 of the 26 lesions existed a little blood flow signal and the other 6 lesions showed no flow signal. During the ultrasound-guided fine-needle aspiration biopsy （US-FNAB）, 21 patients complained about the intolerable serious pain and the pain relieved when the needle removed. Conclusion Traumatic neuromas are hypoecho lesions located in the operation area after neck dissection in PTC with distinctive ultrasonographic features, especially the direct continuity with the nerve fiber, as well as the clinical histories and sharp pain during US-FNAB, which can help to diagnose.

关 键 词：超声检查 创伤性神经瘤 颈部淋巴结清扫术 

分 类 号：R739.91[医药卫生—肿瘤] R445.1[医药卫生—临床医学]