甲状腺弥漫性病变合并甲状腺癌应用超声诊断的临床分析  

Clinical analysis of ultrasonographic diagnosis of diffuse thyroid diseases complicated with thyroid cancer

作　　者：李晶[1] LI Jing(Shenyang Ninth People's Hospital,Shenyang 110000,China)

机构地区：[1]沈阳市第九人民医院,110000

出　　处：《中国现代药物应用》2022年第12期103-105,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨甲状腺弥漫性病变合并甲状腺癌应用超声诊断的价值。方法选取90例甲状腺弥漫性病变合并结节患者作为研究对象,均进行超声检查及手术治疗,并行病理组织学检查,统计术后病理诊断结果,以术后病理诊断作为金标准,分析超声诊断结果及良恶性结节的超声影像特征。结果90例患者术后病理诊断显示:甲状腺弥漫性病变为桥本甲状腺炎者22例(24.44%),Grave's病68例(75.56%);甲状腺结节诊断显示良性结节26例(28.89%),恶性结节64例(71.11%)。26例良性结节患者中,腺瘤(46.15%)占比最高,其次为结节状腺炎、慢性甲状腺炎症、亚急性甲状腺炎;64例恶性结节中,乳头状癌(60.94%)占比最高,其次为腺样囊性肿瘤、滤泡状癌。以术后病理诊断为金标准,超声对甲状腺弥漫性病变合并甲状腺癌的诊断灵敏度为96.88%(62/64),特异度为92.31%(24/26),准确率为95.56%(86/90)。良性和恶性结节多为内部低回声,少量为不均匀回声,内部高回声极少。良性结节边界多清晰,部分边界不清晰;而恶性结节边界多不清晰,边界清晰者较少,但存在部分边界清晰者。良性结节形态规则或不规则;恶性结节形态多不规则,少量为形态规则。良性结节多存在1~2处点状的血流信号,或周围血流信号丰富,结节内部多有微弱的血流信号;恶性结节内部多存在丰富血流信号,血管呈现树枝状,血管数量>4条,无血流分布者较少。良性结节多伴有钙化,以点状钙化为主;而较多恶性结节存在钙化,以斑状或点状为主。结论超声对甲状腺弥漫性病变合并结节的鉴别诊断准确性较高,对合并甲状腺癌患者诊断灵敏度较强,可作为该类疾病筛查的首选筛查、诊断方式。Objective To discuss the value of ultrasonographic diagnosis of diffuse thyroid diseases complicated with thyroid cancer.Methods A total of 90 patients with diffuse thyroid diseases and nodules were selected as the research subjects,all of them underwent ultrasonography,surgical treatment,and histopathological examinations.The postoperative pathological diagnosis was counted,and the postoperative pathological diagnosis was used as the gold standard to analyze the ultrasound diagnostic results and the ultrasound imaging characteristics of benign and malignant nodules.Results Postoperative pathological diagnosis of 90 patients showed that the diffuse thyroid disease were Hashimoto's thyroiditis in 22 cases(24.44%)and Grave's disease in 68 cases(75.56%).The diagnosis of thyroid nodules showed 26 cases(28.89%)of benign nodules and 64 cases(71.11%)of malignant nodules.Among the 26 patients with benign nodules,adenomas(46.15%)accounted for the highest proportion,followed by nodular adenitis,chronic thyroid inflammation,and subacute thyroiditis.Among the 64 malignant nodules,papillary carcinoma(60.94%)accounted for the highest proportion,followed by adenoid cystic tumor and follicular carcinoma.Taking postoperative pathological diagnosis as the gold standard,the diagnostic sensitivity of ultrasound for diffuse thyroid diseases combined with thyroid cancer was 96.88%(62/64),the specificity was 92.31%(24/26),and the accuracy was 95.56%(86/90).Benign and malignant nodules were mostly hypoechoic,a few are heterogeneous,and rarely hyperechoic.Benign nodules had clear borders,and some were not clear;while malignant nodules had less clear borders,but some had clear borders.Benign nodules were regular or irregular in morphology;malignant nodules were mostly irregular in morphology,and a few were regular in morphology.In benign nodules,there were mostly 1-2 punctate blood flow signals or abundant blood flow signals around the nodules,and there were mostly weak blood flow signals inside the nodules;in malignant nodules,there were

关 键 词：超声 甲状腺弥漫性病变 结节 甲状腺癌 甲状腺炎 Grave's病 

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] R581[医药卫生—临床医学]