桥本甲状腺炎合并结节超声影像及病理特征分析

Ultrasonographic and Pathological Characteristics of Hashimoto's Thyroiditis with Nodular Lesions

目的结合病理探讨桥本甲状腺炎(HT)合并结节的超声影像学特点。方法对病理确诊的83例HT患者(病例组)及同期健康查体者60例(对照组)行超声检查,超声测量甲状腺大小并观察甲状腺实质回声及合并结节的特点,记录甲状腺实质、伴发结节血流分布状况及病理特征。结果 HT甲状腺大小明显大于对照组;HT甲状腺回声弥漫性减低、网格状改变、腺体内血流较对照组有明显增加,以上改变与淋巴细胞浸润程度及纤维化改变密切相关;HT合并结节:43例HT合并微结节(51.81%),12例合并桥本结节(14.46%),3例甲状腺腺瘤(3.61%)、5例结节性甲状腺肿(6.02%)、2例甲状腺乳头状癌(2.41%)。结论 HT合并结节的超声影像学特点与病理学改变密切相关。

Objective To explore the ultrasonographic and pathological characteristics of Hashimoto＇s thyroiditis （HT） with nodular lesions. Methods Uhrasonography was performed in 83 patients with HT confirmed by pathology and 60 normal control subjects. The ultrasonographic characteristics including size, echo,and blood flow distribution in the thyroid glands and nodules were analyzed. The laboratory parameters of thyroid function and pathological changes were determined. Results The size of thyroid gland in HT patients was signiticantly larger than that in control subjects. In HT patients,the ultrasonographic characteristics of the thyroid gland,including diffuse hypoechoic parenchyma, multiple liner bright echoes throughout the parenchyma, and increased blood flow, were closely correlated with the infiltration of lymphocytes and the fibrosis of connective tissue. Of these 83 patients, 43 （51.81%） had micronodule, 12 （14.46%） had Hashimoto＇s nodule, 10 had thyroid adenoma （3.61%）,5 （6.02%） had nodular goiter, and 2 （2.41%） had papillary thyroid carcinoma. Conclusion The characteristics of HT with nodular lesions are closely correlated with the pathological changes.