超声评估甲状腺细针穿刺术后急性甲状腺肿胀的临床价值  

Clinical value of ultrasound in the evaluation of acute thyroid swelling after fine needle aspiration

作　　者：朱新艳 关晶波[1] 李昀霖 李知轩 郜颉 张大鹍 Zhu Xinyan;Guan Jingbo;Li Yunlin;Li Zhixuan;Gao Jie;Zhang Dakun(Department of Ultrasound,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院超声科,北京100091

出　　处：《中国医学前沿杂志（电子版）》2024年第8期59-63,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：中国中医科学院科技创新工程项目(CI2021A03317)。

摘　　要：目的分析总结甲状腺细针穿刺后发生急性甲状腺肿胀的患者的超声表现及临床的意义。方法选取中国中医科学院西苑医院2018年5月至2024年4月进行甲状腺细针穿刺后出现急性甲状腺肿胀的7例患者,并纳入2024年4月以前中英文文献中18例患者,将25例甲状腺细针穿刺后出现急性甲状腺肿胀的患者资料进行汇总分析。结果25例患者中,双侧肿大18例(72%),单侧肿大7例(28%);急性甲状腺肿胀发生在穿刺过程中11例(44%),发生在穿刺结束14例(56%);有创治疗(气管插管)1例(4%),药物治疗(止痛、非甾体抗炎药或激素类)7例(28%),非药物治疗17例(68%);<24 h恢复正常19例(76%),≥24 h恢复正常6例(24%);严重并发症(心脏停搏)1例(4%),轻微并发症(疼痛、肿胀)15例(60%),无症状9例(36%)。超声表现为:甲状腺单侧或双侧肿大伴有线样、裂隙样低-无回声区或斑片状低-无回声区,甲状腺血流情况一般无显著改变。结论甲状腺细针穿刺后急性甲状腺肿胀具有自限性,有特征性超声表现,临床及超声医生要提高对该病的认识和重视程度。Objective To analyze and summarize the ultrasonic manifestations and clinical value of patients with acute thyroid swelling after thyroid fine needle aspiration(FNA).Methods Data from seven patients who developed acute thyroid swelling after FNA between May 2018 and April 2024 in Xiyuan Hospital were collected.Additionally,18 cases from relevant Chinese and English literature published before April 2024 were included for a comprehensive analysis,resulting in a total of 25 cases.Results Among the 25 patients,bilateral enlargement was observed in 18 cases(72%),while unilateral enlargement was seen in 7 cases(28%).Acute thyroid swelling occurred during the puncture process in 11 cases(44%)and after the puncture in 14 cases(56%).Invasive treatment(endotracheal intubation)was reported in 1 case(4%),requirement of medication for pain relief(pain relief,non-steroidal anti-inflammatory drugs,or steroids)was reported in 7 cases(28%),no medication is required in 17 cases(68%).Normalization within<24 hours was observed in 19 cases(76%),while≥24 hours normalization was seen in 6 cases(24%).Severe complications(cardiac arrest)occurred in 1 case(4%),with mild complications(pain,swelling)in 15 cases(60%),and asymptomatic in 9 cases(36%).Ultrasonographic findings:unilateral or bilateral goiter with linear,fissure like low echo or patchy low echo areas,thyroid blood flow did not show significant change.Conclusions Acute thyroid swelling after thyroid FNA is self-limiting and has characteristic ultrasound manifestations.Clinical physicans and sonographer should improve the understanding and attention to the disease.

关 键 词：急性甲状腺肿胀 并发症 细针穿刺 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581.3[医药卫生—诊断学]