甲状腺癌的超声误诊分析

目的 分析甲状腺癌超声图像特征,降低超声误诊或漏诊率.方法 总结术后病理确诊,超声误诊、漏诊的37例甲状腺癌声像图特征,进行声像图与病理对照回顾分析.结果 病理诊断的37例甲状腺癌,乳头状癌28例,滤泡癌3例,髓样癌4例,鳞癌1例,转移癌1例.声像图分4型:①实质型;②实质并钙化型;③以液性为主混合型;④以实性为主混合型.甲状腺癌结节内细小钙化点7例,结节边界呈"毛玻璃"征6例,伴颈部淋巴结肿大者12例.甲状腺两种疾病并存5例.结论 甲状腺内低回声结节内细小光点有诊断价值,结节边界呈"毛玻璃"征,具有特异性.应用多项指标综合分析,遇到甲状腺内多个结节,比较结节间的声像图关系,对可疑结节进行超声引导下穿刺活检,能够提高超声诊断甲状腺癌的准确率.

Analysis of Thyroid Carcinoma Sonographic Disdiagnosis

Objective To analyze the character of thyroid sonogram,in order to decrease the rate of ultrasound disdiagnosis or missed diagnosis.Methods The sonogram character of 37 cases of thyroid carcinoma was summarized,which were final diagnosed by pathology but disdiagnosed or missed disagnosis by ultrasound,and a retrospective analysis of sonogram and pathology was conducted.Results In the 37 cases of thyroid carcinoma diagnosed by pathology,there were 28 cases of papillary thyroid carcinoma,3 cases of follicular thyroid carcinoma,4 cases of medullary thyroid carcinoma,1 case of squamous thyroid carcinoma and 1 case of metastatic carcinoma.The sonographic character contains 4 types: parenchyma,parenchyma and calcification,mixed type containing most of fluidity,mixed type containing most of parenchyma.The 7 cases of thyroid carcinoma had fine calcification in the nodus,6 cases showed frosted glass around nodus,12 cases accompanied neck lymphadenectasis,5 cases owned two thyroid diseases.Conclusion The small light-spot in the low echo-level nodus of thyroid had diagnostic value.The sign of frosted glass around nodus has specificity in the diagnosis of thyroid carcinoma.When polynodus in the thyroid was found employing multiple index to aggregate analysis,it is better to compare the sonographic relation among the nodus.If possible puncturing the doubtful nodus directed by ultrasound to biopsy should be performed,so that the rate of accuracy in the thyroid carcinoma diagnosis by ultrasound was increased.