误诊为甲状腺癌的38个甲状腺良性结节超声声像图分析

Analysis of ultrasonographic characteristics of 38 benign thyroid nodules misdiagnosed as thyroid carcinoma

目的分析38个甲状腺良性结节误诊为甲状腺癌的超声声像图特征。方法整理误诊为甲状腺癌的27例38个甲状腺结节超声图像特征,总结每个结节不同恶性特征出现的频率,判断每种恶性特征在甲状腺癌假阳性诊断中的意义,根据术后病理报告分析出现这些恶性特征的原因。结果甲状腺结节恶性特征中实性低回声出现甲状腺癌假阳性率最高,其次是纵横比>1,再次是边缘不规整,而微小钙化的甲状腺癌假阳性率最低,不同结节大小的甲状腺癌假阳性率无明显差异。结论甲状腺结节内部及周边组织成分改变,以及基础性疾病的存在,都可使甲状腺结节的图像特征趋向恶性,使甲状腺癌误诊率升高,值得临床重视。

Objective To analyze and summarize the characteristics of 38 benign thyroid nod- ules misdiagnosed as thyroid carcinoma in order to reduce the misdiagnostic rate. Methods Twenty - seven cases with 38 ultrasonographic characteristics of benign thyroid nodules misdiagnosed as thyroid car- cinoma were selected, and summarize the frequency of occurrences of every nodule＇ s malignant characteris- tics. Assess the significance of malignant characteristics in diagnosis of thyroid carcinoma＇ s false positive, and then find out the reasons of malignant characteristics from pathological report. Results The frequency of false positive of thyroid cancer in malignant hypoechoic nodules of malignant thyroid nodules ： the high- est is solid low echo, which followed by aspect ratio, then the irregularity edge and the last is mierocalci- fieations. There was no significant difference in thyroid carcinoma＇ s false positive rate between different size of nodules. Conclusion Component＇ s changes of thyroid nodules＇ s internal and surrounding, the underlying disease of thyroid, they all can make ultrasonographic characteristics of benign thyroid nodules malignant and improve the misdiagnostic rate. And they are worthy of clinical study.