声像图特征在甲状腺肿块超声诊断与鉴别诊断中的重要价值

Sonographic Features of Thyroid Ultrasound in the Diagnosis and Differential Diagnosis of Significant Value

目的探讨甲状腺肿块的超声声像图特征对其诊断与鉴别诊断的重要性。方法观察362例甲状腺肿块的声像图表现,包括各类甲状腺肿块的部位、数目、形态、大小、有无包膜、边界与边缘、后方有无衰减、有无声晕及声晕宽窄、内部回声、囊性或实性、有无钙化及钙化特征、内部血流及周边血流情况、周边淋巴结等,以病理诊断为依据,总结分析各肿块超声的图像特征、及其在相应诊断与鉴别诊断中的作用,并不断实践得以完善。结果经病理证实的362例甲状腺肿块中,134例乳头状癌,81例微小乳头状癌,滤泡性癌5例,6例髓样癌,66例腺瘤(除滤泡性腺瘤24例外,其余为不典型腺瘤、腺瘤囊性变等),62例结节性甲状腺肿,8例其他如甲状腺囊肿、未分化癌等,绝大部分表现有与病理分型相对应的超声声像图改变;虽有相当一部分为多种病例混合存在,但也能依据各自的特征加以区别诊断。结论各种病例总结后发现,不同病理分型均有一定的声像图特点与之对应,因而超声检查在甲状腺肿块中不可或缺,在甲状腺良、恶性肿瘤的临床诊断和鉴别诊断中有重要价值,是实用而有效的一种方法。

Objective To evaluate the sonographic features and it’s diagnosis value for the thyroid lumps.Method 362 cases sonographic features with thyroid lumps were observed,including the location,number,shape,size,with or without capsule,borders and edges,the rear with or without attenuation,silence and sound halo,internal echoes,cystic or solid,with or without calcification and calcification characteristics,and the surrounding blood flow within the blood,peripheral lymph nodes.According to pathological diagnosis,we summarized and analyzed ultrasound characteristics of the tumors,and their corresponding diagnosis and differential diagnosis values.Result 362 cases with thyroid lumps were verified by pathology,including 134 cases papillary carcinomas,81 cases small papillary carcinomas,5 cases follicular carcinomas,6 cases medullary carcinomas,66 cases adenomas（24 cases follicular adenomas,the rest are atypical adenomas or cystic adenomas）,62 cases nodular goiters,and 8 others such as thyroid cysts,undifferentiated carcinomas etc.Most of the sonographic manifestations correspond to their pathological types;although a considerable part cases containing various pathological types,but we can still diagnose on the basis of their sonographic characteristics.Conclusion The different pathological types have certain characteristics of the corresponding ultrasound sonogram.Therefore,ultrasound examination is important in the diagnosis and differential diagnosis of thyroid benign or malignant tumors,it may be used as a practical and effective method for thyroid lumps.