超声联合ACR-TIRADS分类对良性甲状腺囊实性结节囊液吸收后病灶的诊断  

Diagnosis of Lesions After Absorption of Benign Solid-Cystic Thyroid Nodules By Ultrasonography Combined with ACR-TIRADS

作　　者：詹韵韵[1] 彭梅[1] 姜凡[1] Zhan Yunyun;Peng Mei;Jiang Fan(Department of Ultrasound,the Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声诊断科,合肥市230601

出　　处：《中国超声医学杂志》2020年第10期872-875,共4页Chinese Journal of Ultrasound in Medicine

基　　金：安徽省重点研究与开发计划项目(No.201904a07020068)。

摘　　要：目的总结良性甲状腺囊实性结节囊液吸收后病灶的声像图特征,提高超声检查对该类病灶的诊断水平。方法运用2017版ACR-TIRADS分类回顾性分析81个良性甲状腺囊实性结节囊性成分吸收后病灶的声像图,归纳总结图像特征,所有病灶均经手术或细针穿刺病理证实为良性。结果81个吸收后病灶中38个病灶表现为"类微乳头状癌型",超声多表现为低回声,垂直位分布,边缘不规则,伴微钙化,TIRADS 3类5个、4类8个、5类25个。27个病灶周边出现特异度"双边征"征象,TIRADS 3类2个、4类21个、5类4个。16个病灶表现为"类炎症型",声像图表现为原结节部位出现片状低回声,占位效应不明显,TIRADS 4类13个、5类3个。结论良性甲状腺囊实性结节囊液吸收后病灶的声像图有一定的特征性,总体TIRADS分类级别较高。出现于原囊实性结节部位、体积缩小、内有少量囊性成分及"双边征",上述征象有助于该类病灶的鉴别诊断,可适当下调TIRADS分类级别,避免过度治疗。Objective To explore the ultrasonographic features of the lesions after absorption of benign solid-cystic thyroid nodules,to improve the diagnostic level for such lesions by ultrasonography.Methods A retrospective analysis of 81 lesions after the absorption of benign solid-cystic thyroid nodules by ACR-TIRADS(2017)was used to summarize the ultrasonographic features.All lesions were confirmed as benign by surgery or fine needle puncture pathology.Results 38 absorbed lesions showed"papillary microcarcinoma type".Most of the sonographic features of 38 absorbed lesions were hypoechoic,vertical distribution,irregular margin and microcalcifications.There were 5 cases of 3,8 cases of 4 and 25 cases of 5 classified by TIRADS.27 absorbed lesions showed specific"bilateral sign"signs.There were 2 cases of 3,21 cases of 4 and 4 cases of 5 classified by TIRADS.16 absorbed lesions were characterized as"inflammatory type".The ultrasonoscopyes showed that the site of the original noclule was hypoechoic and the occupying effect was not obvious.There were 13 cases of 4 and 3 cases of 5 classified by TIRADS.Conclusions The lesions after the absorption of benign solid-cystic thyroid noclule have certain ultrasonographic characteristics.TIRADS classification level is high generally.The lesions appear in the site of the original nodules and the volume are smaller.The lesions have small cystic components and"bilateral signs".These findings are helpful for the correct diagnosis of the lesions.TIRADS classification level can be appropriately lowered to avoid excessive treatment.

关 键 词：甲状腺囊实性结节 良性 吸收后 超声检查 甲状腺影像报告数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]