超声在慢性淋巴细胞性甲状腺炎背景下的结节诊断中的价值

目的分析超声在慢性淋巴细胞性甲状腺炎（CLT）背景下的甲状腺良恶性结节诊断中的价值。 方法选取2015年1月至2017年12月就诊于苏州大学附属第一医院的398例甲状腺结节患者的灰阶和彩色多普勒超声图像进行回顾性分析。按照病理结果分为4组：正常背景下的良性结节组（BN）、正常背景下的甲状腺乳头状癌组（PTC）、CLT背景下的良性结节组（CLT＋BN）和CLT背景下的PTC组（CLT＋PTC）。 结果不同背景下的恶性结节和良性结节各自的超声特征均相似，差异均无统计学意义（P均>0.05），但是，结节内部的血流信号存在差异，差异有统计学意义（P=0.001），而CLT背景下的良恶性结节的超声特征包括纵横比、内部回声、形态、边界、钙化灶、血流信号特征等超声特征表现上比较，差异均有统计学意义（P均<0.001）。 结论CLT背景的存在与否对PTC的鉴别无明显干扰，在CLT患者中，常规超声依然能够很好的帮助判断结节的性质，为临床提供可靠的诊断依据。但是，彩色血流特征在结节的鉴别诊断中价值有限。

Value of ultrasonography in diagnosis of nodules in patients with chronic lymphocytic thyroiditis

Objective To assess the value of ultrasonography in the diagnosis of nodules in patients with chronic lymphocytic thyroiditis(CLT).Methods We collected the data for patients with thyroid nodules at the First Affiliated Hospital of Soochow University from January 2015 to December 2017.A total of 398 thyroid nodules from 398 patients which were pathologically confirmed were included in this retrospective study.Gray-scale ultrasound and color Doppler images of these thyroid nodules were analyzed.According to the postoperative pathological findings,these cases were divided into four groups:benign nodules without CLT group(BN),PTC without CLT group(PTC),benign nodules with CLT group(CLT+BN),and PTC with CLT group(CLT+PTC).Results The ultrasonographic characteristics of PTC with or without CLT were similar(P>0.05),except the blood flow inside the nodule(P=0.001).Most of the ultrasonic features differed significantly between PTC and benign nodules with CLT,such as long to short dimension ratio,echo,shape,border,microcalcifications,and blood flow signal.Conclusion Conventional ultrasound is useful for the detection of benign or malignant nodules with CLT.CLT has no significant effect on the ultrasonographic diagnosis of PTC.The value of color Doppler blood flow characteristics in the differential diagnosis of nodules is limited.