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目的分析甲状腺病变的超声表现,探讨各种甲状腺病变超声诊断要点、漏诊、误诊原因。方法回顾性分析72例经临床和手术病理证实的甲状腺病变的超声资料。结果超声诊断病理符合60例(符合率为83.33%),误诊8例(误诊率为11.11%),漏诊4例(漏诊率为5.56%)。7例误诊包括:结节性甲状腺肿(24例)误诊2例(2/24),其中1例误诊为甲状腺癌,1例误诊为甲状腺瘤;甲状腺癌(32例)误诊为甲状腺瘤3例(3/32);桥本病(1例)误诊为甲状腺癌1例;甲状腺瘤(12例)误诊为甲状腺癌1例(1/12);Graves病(3例)误诊为桥本病1例。4例漏诊:结节性甲状腺肿1例,甲状腺癌2例,甲状腺瘤1例,原因分别为缺乏对临床资料的了解和经验不足、结节声像图表现不典型、多源性结节并存。结论甲状腺病变与正常腺组织及周围结构的关系,以及有无淋巴结肿大、转移是甲状腺病变定性诊断的主要依据,仔细观察甲状腺结节的二维及彩色多谱勒超声征象,并结合临床分析可以减少漏、误诊的发生。
Objective To analyze the ultrasonographic features of thyroid lesions and to explore the main points of ultrasonic diagnosis, causes of missed diagnosis and misdiagnosis of thyroid lesions. Methods A retrospective analysis of 72 cases of thyroid lesions confirmed by clinical and surgical pathology ultrasound data. Results Ultrasound diagnosis was found in 60 cases (83.33%), misdiagnosis in 8 cases (misdiagnosis rate was 11.11%) and missed diagnosis in 4 cases (misdiagnosis rate was 5.56%). Seven cases of misdiagnosis included: nodular goiter (24 cases) misdiagnosed in 2 cases (2/24), of which 1 case was misdiagnosed as thyroid cancer and 1 case was misdiagnosed as thyroid adenoma; Thyroid cancer (32 cases) was misdiagnosed as thyroid adenoma in 3 cases (3/32); Hashimoto’s disease (1 case) misdiagnosed as thyroid cancer; thyroid adenoma (12 cases) misdiagnosed as thyroid cancer in 1 case (1/12); Graves disease (3 cases) misdiagnosed as Hashimoto’s disease 1 example. 4 cases of missed diagnosis: 1 case of nodular goiter, 2 cases of thyroid cancer, thyroid tumor in 1 case, respectively, due to the lack of clinical data and lack of experience, nodular sonography was not typical of multi-source nodules co-exist . Conclusions The relationship between thyroid lesions and normal glandular tissues and their surrounding structures, as well as the presence or absence of lymphadenopathy and metastasis are the main bases for the qualitative diagnosis of thyroid lesions. The two-dimensional and color Doppler sonographic findings of thyroid nodules are carefully observed and combined with clinical analysis Can reduce leakage, misdiagnosis.