超声误诊58例临床分析

目的：探讨甲状腺结节超声误诊原因，旨在进一步提高超声影像学对甲状腺结节的诊断水平。方法：对2006～2011年间手术治疗的58例甲状腺结节患者超声及病理诊断进行回顾性分析。结果：超声诊断正确14例，误诊33例，漏诊11例。33例误诊病例中恶性误诊为良性者4例，良性误诊为恶性者1例；结节性甲状腺肿误诊为腺瘤3例，结节性甲状腺肿囊性变误诊为腺瘤囊性变25例；11例漏诊病例中，8例结节性甲状腺肿合并腺瘤，其中6例漏诊结节性甲状腺肿，2例漏诊腺瘤；2例腺瘤合并慢性淋巴细胞性甲状腺炎，1例结节性甲状腺肿合并慢性淋巴细胞性甲状腺炎，均漏诊了慢性淋巴细胞性甲状腺炎。结论：对甲状腺结节声像图的多样性，多源性结节共存，良恶性特征交叉重叠认识不足，对甲状腺腺瘤，结节性甲状腺肿，甲状腺癌等的声像图特点掌握不够是误诊的主要原因。

Misdiagnosis Analysis of the Ultrasonographic Images of Thyroid Nodule

Objective：To improve the level of uhrasonic differential diagnosis of thyroid nodules through analyzing the factors for misdiagnosis in ultrasonographic evaluation of thyroid nodules. Methods：During 2006 -2011 years the pre operative diagnosis of uhrasonography in 58 patients with thyroid nodules were retrospectively reviewed in light of their pathologic results. Results：The pre operative ultrasonography correctly diagnosed 14 cases, with incorrect diagnosis in 33 cases and missed diagnosis in 11 eases. There are 4 malignant patients who were misdiagnosed to be benign, 1 be- nign patient who was misdiagnosed to be malignant in 33 misdiagnosed cases; There are 3 nodular goiter patients who were misdiagnosed as adenoma, 25 nodular goiter with cystic degeneration patients who were misdiagnosed as adenoma with cystic degeneration; In 11 cases of missed diagnosis, 8 cases of nodular goiter and adenoma, 2 cases of adenoma associated with chronic lymphocytic thyroiditis, 1 case of nodular goiter associated with chronic lymphocytic thyroiditis. 6 cases of nodular goiter were missed, 2 cases of adenoma were missed, 3 cases of chronic lymphocytic thyroiditis were missed. Conclusions：There are two main causes for misdiagnosis. One is the insufficient perception of the ultrasonic images diversity of thyroid nodule, the multiple nodules coexisted and benign and malignant features overlap. The other is the insufficient mastery for the uhrasonographic characteristics of the thyroid adenoma, nodular goiter and thyroid carcinoma.