结节性甲状腺肿合并甲状腺癌的超声诊断及其误诊分析

目的探讨结节性甲状腺肿合并甲状腺癌的超声特征,并对其误诊进行分析,提高超声对本病的诊断率。方法回顾性分析46例行手术病理证实的结节性甲状腺肿合并甲状腺癌患者的超声图像,观察癌结节的大小、形态、边界、包膜、内部回声、血流分布特点与结节肿良性结节的超声图像并进行对照分析。结果超声诊断与病理诊断的符合率54.3%,结节性甲状腺肿合并甲状腺癌声像图常表现为肿瘤结节形态不规整,边缘不清,内部呈不均质低回声,常见散在分布的微小钙化,结节内部及周边血流信号丰富,为Ⅱ级高速高阻血流信号,个别可探及颈部或锁骨上肿大淋巴结。结论超声对结节性甲状腺肿合并甲状腺癌的诊断有重要的临床价值,综合分析结节性甲状腺肿合并甲状腺癌的声像图特征,找出其检出率低的原因,将有助于提高结节性甲状腺肿合并甲状腺癌的诊断准确性。

Ultrasound Diagnosis for Nodular Goiter with Concurring Thyroid Cancer and Misdiagnostic Analysis

Objective To explore the ultrasound characteristics of nodular goiter with concurring thyroid cancer and analyze the misdiagnosis in an attempt to improve ultrasound diagnosis of this disease. Methods Forty-six cases of pathologically confirmed nodular goiter with concurring thyroid cancer in ultrasound images were retrospective analyzed, and the cancer nodule size, shape, borders, capsule, internal echo and blood flow distribution were observed in nodular goiter with concurring thyroid cancer and benign nodular goiter and their ultrasound images were comparatively analyzed. Results The coincidence rate of the ultrasound diagnosis with pathological diagnosis was 54.3%, tumor nodule sonogram of nodular goiter with concurring thyroid cancer were usually manifested as irregular shape, unclear edge, common sporadic distribution of small calcification, no homogeneous low echo and the rich blood flow signals within and around the nodules as 1I high-speed high-resistance flow signals. Individually, lymphadenectasis of neck or supraclavicular lymph node can be explored. Conclusion Ultrasound has important clinical value in the diagnosis of nodular goiter with concurring thyroid cancer, and the comprehensive analysis of the image features to find out the reasons for the low detection rate will help to improve its diagnostic accuracy.