结节性甲状腺肿的二维及彩色多普勒声像图特点与误诊分析

目的 分析结节性甲状腺肿的二维及彩色多普勒声像图特点，并对其误诊原因进行分析，旨在提高对结节性甲状腺肿诊断的准确率。方法 对46例结节性甲状腺肿的二维声像图及彩色血流与手术病理结果对照分析。结果 46例结节性甲状腺肿中，单发型结节13例(占28．2％)，表现为甲状腺内单个实性、囊性和混合性回声。多发型结节14例(占30．4％)，表现为多个囊性和混合性回声，对称性分布在一侧或两侧叶甲状腺内。弥漫性结节19例(占41．4％)，表现为甲状腺不对称肿大，其内布满了大小不等的结节。对其中9例误诊为甲状腺腺瘤和甲状腺癌的原因进行分析。结论 结节性甲状腺肿的声像图表现复杂多样，血流信号无特异性，对多个囊实性混合回声结节首先考虑结节性甲状腺肿。对单个边界尚清的实性和囊实性混合回声结节，结合内部回声、囊壁厚度和液性暗区内有无光带分隔、包膜是否完整、有无晕环等，进行综合分析。

Characteristics of Colour Doppler Flow Imaging and Two Dimensional Imaging of Nodular Goiter and Pitfalls

Objective In order to promote diagnostic accuracy of nodular goiter, we analyzed the characteristics of CDFI and two dimensioonal imaging of nodular goiter and the cause of misdiagnosis. Method To analyze and compare the characteristics of images with pathology results in 46 cases of nodular goiter. Results 13 cases were isolated node type (accout for 28.2%) and showed isolated solid , cystic and mixed masses , 14 cases were mutiple node type (account for 30.4%) and showed multi-cystics and mixed masses distributed in one or both sides of thyroid, 19 cases were diffuse nodule type, and thyroid swelled asymmetrically We misdiagnosed 9 cases as thyroid carcinoma or thyroid adenoma. Conclusion The imaging of the nodular goiter is complex, and blood flow is non-specific,and multiple solid and mixed nodular lesions in thyroid be considered as nodular goiter. The diagnosis of Small single nodular with mixed echoes and clear borders should be based on the concrete characteristics of images like internal echoes, thick cystic wall, the anechoic area with or without septation, the continuity of capsules, the clearness of the boundary and the echo hale et al.