桥本甲状腺炎合并良恶性病变超声图像对比分析

Comparative analysis of ultrasound images of Hashimoto thyroiditis with benign or malignant lesions

目的探讨超声在桥本甲状腺炎合并良恶性病变诊断中的价值。方法本组病例:桥本甲状腺炎合并甲状腺癌82例,合并良性病变87例,结合病理结果和术前超声检查,总结其声图像特点进行对比分析。结果桥本甲状腺炎合并甲状腺良恶性病变时,在超声图像上有其明显的特征表现,二者差异有统计学意义,桥本甲状腺炎合并甲状腺癌有如下特点:结节多呈低回声,边缘不规整,无明显包膜;多伴有砂砾样钙化;有的局部腺体回声明显减低,伴有弥漫性的砂砾样钙化,血流显示多为结节内的条状血流。良性病变结节多轮廓清晰,结节内回声高低不等,少有砂砾样钙化,结节周边多可见血流显示。结论对桥本状腺炎合并其他病变时,超声检查应注意腺体回声情况及腺体内病变的回声情况进行全面分析和判断;对于结节形态不规则、边界不清晰、伴有钙化灶、衰减应注意有恶性病变变的可能。

Objective To investigate the value of ultrasound in the diagnosis of Hashimoto thyroiditis with benign and malignant lesions.Methods 82 cases of Hashimoto′s thyroiditis with thyroid cancer and 87 cases of Hashimoto′s thyroiditis with benign lesions were enrolled in the study.The pathological findings and preoperative ultrasonography were analyzed.Results There were significant differences between the Hashimoto thyroiditis patients with benign lesions or those with thyroid cancer.The manifestation of Hashimoto thyroiditis with thyroid cancer had following characteristics： The nodule was usually hypoechoic with irregular edge,no obvious capsule and often accompanied with gravel-like calcification;Ultrasonic echo of some local glands was significantly reduced with diffused calcification of the local glands;The blood flow display showed strip bloodstream in multiple nodules.The benign lesions usually had clear outlines,various ranges of echo,rare gravel calcification,as well as visible blood flow in the surrounding.Conclusion It should be noted that malignant lesions may exist if Hashimoto thyroiditis is combined with other lesions in which the ultrasound show irregular nodular morphology and unclear border associated with calcification.