甲状腺结节后方声影的评估

Assessment of acoustic shadows of thyroid nodules

目的探讨各种原因所致甲状腺结节后方声影的特点。方法选取甲状腺超声检查后方有声影的病例456例,根据其长短、宽窄、立体感等特点对各种原因所致声影进行分析。结果 456例中,超声诊断甲状腺结节伴钙化224例(224/456,49.12%),甲状腺实质性占位172例(172/456,37.72%),甲状腺术后瘢痕改变12例(12/456,2.63%),胸锁乳突肌内缘干扰所致结节声影48例(48/456,10.53%)。241例患者接受手术,经病理证实单纯性结节性甲状腺肿伴钙化45例,结节性甲状腺肿伴纤维化88例,甲状腺恶性肿瘤108例。甲状腺结节伴钙化及甲状腺占位的后方声影立体感明显,其中前者以长、宽声影居多,后者以短、窄声影居多;术后瘢痕及胸锁乳突肌内缘干扰所致的后方声影立体感差。结论不同原因所致甲状腺结节后方声影的形态有明显差异,认识这些特点有助于超声医师正确诊断甲状腺结节。

Objective To assess the characteristics of acoustic shadows in thyroid nodules from different origins.Methods Acoustic shadows were found in a total of 456 patients who underwent thyroid ultrasound.The length,width and stereognosis of acoustic shadow were analyzed in deferent conditions.Results In 456 cases,ultrasound diagnosed 224 cases（224/456,49.12%） of thyroid nodules with calcification,172 cases（172/456,37.72%） of thyroid suspicious mass,12 cases（12/456,2.63%） of thyroid surgery scar,and interfered by sternocleidomastoid causing acoustic shadow in 48 cases（48/456,10.53%）.Finally,241 patients underwent surgery,and pathology confirmed 45 cases of simple nodular goiter with calcification,88 of nodular goiter with fibrosis and 108 of thyroid cancer.The shadows of thyroid nodules with calcification and thyroid suspicious mass were found in stereognosis,the former were long and wide,while the latter were short and narrow.The acoustic shadow caused by thyroid surgery scar and anterior muscles of neck appeared less prominent when scanned by different stereognosis.Conclusion Acoustic shadows from different origins have different features.Understanding of these characteristics is helpful to making correct diagnosis of thyroid nodules.