超声对桥本甲状腺炎良恶结节的鉴别诊断价值

The value of ultrasound in thyroid nodules with Hashimoto′s thyroiditis background

目的探讨灰阶超声在桥本甲状腺炎背景下鉴别诊断甲状腺良恶性结节的价值。方法超声检查结合病理（包括穿刺活检及术后病理）检查结果回顾性分析我院2010年1月-2013年6月桥本甲状腺炎伴发良性结节患者（56例）和伴发恶性结节（16例）共72个结节（每例患者重点评估1个结节）的超声表现特征。结果桥本甲状腺炎背景下72个甲状腺结节中：77.8%为良性（56/72）,22.2%为恶性（12/72）,恶性结节均为甲状腺乳头状癌,多表现为单发,低回声,不规则形,边界不清,内部回声分布不均,更易发现点状钙化及后方回声衰减;良性结节易多发、部分为高回声,具有低回声晕,多无钙化。良恶性结节发生的甲状腺实质背景类型构成比间有统计学差异（P〈0.05）。在彩色多普勒特征分析中,多数良恶性结节均表现为少许血流信号,两者差异无统计学意义。结论灰阶超声对桥本甲状腺炎背景下甲状腺良恶性结节具有良好的鉴别诊断价值。

Objective To assess the value of ultrasound in differentiating from thyroid nodules with Hashimoto′s thyroiditis background.Methods We retrospectively analysed 72 thyroid nodules（56benign nodules,16 malignant nodules）with Hashimoto′s thyroiditis background,which were verified by surgery and pathology between January 2010 and June2013in our hospital.Results Among 72 nodules with Hashimoto′s thyroiditis background,77.8%（56/72）were benign,22.2%（12/72）were malignant（12papillary carcinoma）.Malignant nodules were more likely to be solitary,hypocchoic,irregular,obecure boundary and aniso-internai.Calcification including microcalcification was more common among ma-lignant nodules.Benign nodules were more likely to be multiple,hyperechoic,having a halo and lacking calcifications.The background echo-genicity of thyroid essence had some differences between benign and malignant nodules.The benign and malignant nodules were all of hypovascularity in color Doppler sonography.Conclusion Gray scale ultrasound is good enough for the differentiation of benign and malignant nodules with Hashimoto′s thyroiditis background.