结节性甲状腺肿和甲状腺腺瘤超声鉴别诊断临床分析

Clinical Analysis of Differential Diagnosis of Nodular Goiter and Thyroid Adenoma by Ultrasonography

目的:分析在超声诊断中结节性甲状腺肿和甲状腺腺瘤的鉴别要点。方法:选择东莞市大朗医院于2020年1月至2021年12月间经病理检查结果证实的31例结节性甲状腺肿患者和29例甲状腺腺瘤患者作为研究对象,分别为观察组和对照组,评估两组患者的超声图像特征、血流动力学。结果:经对比发现,观察组的病灶个数以多发为主,且病灶直径多<1cm,边界清晰,对照组则以单发为主,病灶直径在1-3cm和>3cm左右,边界清晰;观察组的实性内部回声小于对照组,P<0.05;晕环征、包膜征少于对照组,P<0.05;观察组的血流动力学指标以0-Ⅰ级为主,对照组以Ⅱ-Ⅲ级为主;观察组的结节内血流参数、结节周围血流参数较之对照组差异明显,P<0.05,差异具有统计学意义。结论:在结节性甲状腺肿与甲状腺腺瘤的超声图像鉴别中,可以从病灶数量、直径、边界、内部回声以及是否存在晕环征、包膜征等方面加以鉴别,且两种甲状腺疾病的血流信号、血流动力学指标也存在明显差异。

Objective:To study the key points of ultrasonic diagnosis in nodular goiter and thyroid adenoma.Methods:31 cases of nodular goiter and 29 cases of thyroid adenoma confirmed by pathological examination in Dongguan Dalang Hospital from January 2020 to December 2021 were selected as the study objects,respectively as the observation group and the control group,to evaluate the ultrasonic image characteristics and hemodynamics of the two groups of patients.Results:In nodular thyroid,multiple lesions with diameter less than 1 cm were most common,and the boundary was clear;thyroid adenoma mainly includes single lesion with a diameter of 1~3cm and>3cm,with clear boundary;the internal echo of the observation group was smaller than that of the control group,with significant difference(P<0.05);halo ring sign and capsule sign were less than those in the control group(P<0.05);the hemodynamics of the observation group were mainly distributed in 0~Ⅰgrade,while those of the control group were distributed in II~Ⅲgrade;in addition,the blood flow parameters in and around the nodules of the two groups were significantly different(P<0.05).Conclusion:In the differential diagnosis of nodular goiter and thyroid adenoma,it is recommended to evaluate the lesion,diameter,boundary,echo,etc.In addition,the halo sign and envelope sign can also provide information support for diagnosis,and also provide information for differential diagnosis in terms of blood flow signal and hemodynamics.