桥本甲状腺炎结节恶变的超声诊断

Ultrasonograhy in the diagnosis of hashimoto’s thyroiditis with nodules

目的探讨桥本甲状腺炎结节的二维超声图像特征及脉中多谱勒测及内部RI的数值比较。方法对35例经手术病理证实的桥本甲状腺炎结节患者的术前超声诊断做回顾性研究,其中良性18例,恶性17例。对超声检查中感兴趣结节的两维声像图特征及结节内测及的最高RI(阻力指数)进行比较分析。结果二维超声图像及彩色多谱勒血流分析发现,甲状腺结节的良恶性,在结节形态、边界、结节内部回声性质以及内血流阻力指数(RI)等方面,显示出显著性差异(p<0.05)。恶性结节多表现为结节形态不规则,边界不清晰,实质性内部低回声,以及RI>0.75。而良性结节则表现为形态规则,边界清晰,内部为高或等回声结节,RI<0.75。结节钙化不是判断甲状腺结节良恶性有帮助的指标(p>0.05)。结论两维超声及结节内RI对桥本甲状腺炎恶性结节的鉴别诊断有帮助。

Objective:To investigate the Hashimoto's Thyroiditis with nodules(HT nodules) with high frequency ultrasonography.Methods:35 patients with HT nodules were confirmed by pathology.17 patients suffered from malignant nodules and 18 patients were ill with benign nodules.Reviewed the interested nodules in 2-dimension echography ane the highest RI intranodular.Results:Shape, margin, echo structure, internal echo and RI of thyroid nodules were evidently difference between HT and HT with thyroid cancer (p < 0.05).Malignant nodules manifest irregular shape, ill-defined margin, solid echo, hypoechoic internal echo, and RI > 0.75.But benign nodules show regular shape, well-defined margin hyperechoic or isoechoic internal echo and RI < 0.75.Conclusion:2-dimension echography and the highest RI intranodular are beneficial for differentiating HT nodule.