甲状腺术后缝线肉芽肿超声表现

Ultrasonic features of suture granulomas after thyroid surgery

目的分析甲状腺术后患者颈部手术缝线刺激形成的异物肉芽肿的超声表现。方法回顾性分析47例甲状腺乳头状癌、甲状腺全切术或部分切除术后患者,经超声、细针穿刺细胞学及临床观察诊断86枚颈部肉芽肿结节,观察其声像图特征。结果肉芽肿结节均分布于甲状腺残端边缘或手术区软组织内,表现为低回声结节,无包膜,形态多样,边缘不规则,其内均见多发性点状强回声,后方多伴声影。86枚颈部肉芽肿结节中,80枚显示血流信号稀少(80/86,93.02%),6枚血流丰富(6/86,6.98%);弹性超声检查显示弹性评分2级24枚(24/86,27.91%),3级24枚(24/86,27.91%),4级38枚(38/86,44.19%)。结论甲状腺术后缝线肉芽肿声像图多表现为甲状腺残端或周围颈部软组织内不规则低回声,内部伴集中于结节中心的点状强回声。

Objective To observe ultrasonic manifestations of foreign body granulomas induced by suture stimulation in patients after thyroid surgery.Methods Data of 47 papillary thyroid carcinoma patients who underwent total thyroidectomy or partial thyroidectomy were retrospectively analyzed.A total of 86 neck granulomatous nodules were diagnosed as surgical suture foreign body granuloma with ultrasonography,fine needle puncture cytology and clinical observation,and the ultrasonic characteristics and changes of nodules were observed.Results All 86 suture granuloma nodules located in the margin of the residual thyroid gland or in the soft tissue around the surgical region,presenting as hypoechoic nodules without capsule,with irregular margin and punctate echogenic foci followed by some degree of acoustic shadowing.Color Doppler ultrasound showed that the blood flow signals were scarce in 80 nodules(80/86,93.02%)and abundant in 6 nodules(6/86,6.98%).Elastographic score was assessed,24 nodules(24/86,27.91%)were grade 2,24(24/86,27.91%)were grade 3 and 38(38/86,44.19%)were grade 4.Conclusion Ultrasonic characteristics of suture granuloma after thyroid surgery include mainly irregular hypoechoic in thyroid residual or surrounding neck soft tissue,with internal spot-like strong echo concentrated in the center of nodules.