结节性甲状腺肿超声误诊分析

Misdiagnosis analysis of the sonographic images of nontoxic nodular goiter

目的探讨非毒性结节性甲状腺肿超声误诊原因,提高诊断符合率。方法对超声检查误诊的63例结节性甲状腺肿声像图进行回顾性分析。结果单发结节类35例可分三型:7例为类似囊肿型、10例为类似腺瘤型、18例为腺瘤囊性变型;多发结节类28例可分两型:8例为多发实性结节型、20例囊实结节混合型。全组63例结节以外的腺体回声无异常,结节内仅4例有钙化。结论对结节性甲状腺肿的高发病率及其在甲状腺结节病变中的高比例和对该病病理的复杂性及其图像的多样性认识不足,对甲状腺囊肿、腺瘤的声像特点掌握不够是误诊的主要原因。

Objective To investigate the reason of the ultrasonography misdiagnosis of nontoxic nodular goiter and to raise the diagnostic accuracy. Methods A retrospective study was done on sixty- three patients with nodular goiter misdiagnosed by ultrasonography. Results The 35 cases with single- nodule were divided into three types： kinsmanship cyst pattern （7 cases）, kinsmanship adenoma pattern （10 cases）, cystic adenoma pattern （18 cases）. The 28 cases with multi - nodules were divided into two types： multi- nodular solid pattern （8 cases）, cystic - solid nodular mixed pattern （20 cases）. The thyroid gland echoes besides nodules were natural in all the 63 cases, calcification within the nodule was fotmd in only 4 cases. Conclusion There are two main causes for misdiagnosis. One is the insufficient perception of the high morbility of nodular goiter, the high portion in the thyroid nodules, the pathology complexity and ultrasonic images diversity. The other is the insufficient mastery for the sonographic characteristics of the thyroid cyst and thyroid adenoma.