B超和同位素扫描检查对甲状腺结节疾病的诊断意义

目的 探讨甲状腺结节疾病的B超检查和同位素显像检查的诊断意义。方法 2005年全年我院收治的227例经手术治疗的甲状腺结节疾病患者，术前均行B超检查，随机选取其中151例患者术前行同位素扫描检查。对照手术后病理结果，回顾性分析B超检查和同位素显像的诊断意义。结果 对比病理检查结果，结节性甲状腺肿、甲状腺腺瘤、桥本氏甲状腺炎、甲状腺癌的B超检查与病理诊断符合率，分别为：94％（168／179），90％（28／31），50％（1／2），20％（3／15）。同位素扫描结果：病理诊断为结节性甲状腺肿的112例患者中，冷结节26例、凉结节54例、温结节25例、热结节7例；病理诊断为甲状腺腺瘤的25例患者中，冷结节8例、凉结节16例、温结节1例；病理诊断为桥本氏甲状腺炎的2例患者中，冷结节1例、凉结节1例；病理诊断为甲状腺癌的12例患者中，冷结节9例、凉结节2例、温结节1例。结论 B超检查在鉴别甲状腺结节疾病的单多发性、良恶性、囊实性时，意义较大，可作为筛选甲状腺肿物的重要手段，并可指导手术方案的选择。同位素扫描缺少特异性和准确性，需和病史、体检、B超显像检查相结合。

Diagnosis of ultrasonography and nuclide scan in thyroid nodules diseases

Objective To analyze imaging characteristics of ultrasonography and nuclide scan in diagnosis of thyroid nodules.Methods The comparison was performed with the results of ultrasonography and radionuclide imaging and pathology in 227 thyroid nodule patients.Results The accuracy of ultrasonography for diagnose in nodular goiter was 94%(168/179),the accuracy for diagnosing thyroid adenoma was 90% (28/31),the accuracy for diagnosing Hashimoto's thyroidits was 50%(1/2),the accuracy for diagnosing thyroid carcinoma was 20%(3/15);Results of nuclide scan:In 112 cases of nodular goiter,cold nodules were 26 cases,cool nodules were 54 cases,warm nodules were 25 cases,hot nodules were 7 cases;In 25 cases of thyroid adenoma,cold nodules were 8 cases,cool nodules were 16 cases,warm nodule was 1 case;In 2 cases of Hashimoto's thyroidits,cold nodule was 1 case,cool nodule was 1 case;In 12 cases of thyroid carcinoma,cold nodules were 9 cases,cool nodules were 2 cases,warm nodule was 1 case.Conclusion Ultrasonography is important to identify thyroid nodules;ultrasonography should be used as the primary screening method.Nuclide scan is short of specificity and accuracy in diagnosing thyroid nodules.