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目的:对桥本甲状腺炎(HT)合并结节样病变的超声诊断以及误诊情况进行分析。方法:选取本院在2011年6月-2012年6月收治的55例桥本甲状腺炎合并单发和多发结节患者作为研究对象,全部患者均经过手术及病理学证实,对全部结节样病变的超声影像图进行分析,并对该病的诊断率提高的方式进行讨论。结果:在全部患者中,单个结节24例,合并乳头状癌为7例,合并滤泡性腺瘤为3例;多个结节为31例,合并乳头状癌为5例,合并滤泡性腺瘤为3例,合并结甲11例。其中,35例与病理相符,诊断准确率63.6%,误诊20例,有18例误诊为结节性甲状腺肿,2例为甲状腺癌,误诊率为36.4%。单纯性桥本甲状腺炎结节与甲状腺癌结节,在结节的形态、边界、内部伴有钙化的形态上以及血流信号的分布上有显著差异。结论:全面检查血清学的甲状腺抗体,并关注结节之外的腺体回声以及腺体供血的状况;应该高度注意结节是否出现形态不规则、伴有钙化灶以及边界模糊的特征,提示恶变的可能,给临床医生以最有价值的提示,全面提高超声的正确诊断率。
Objective: To analyze the ultrasonic diagnosis and misdiagnosis of Hashimoto’s thyroiditis (HT) combined with nodular lesions. Methods: Fifty-five Hashimoto’s thyroiditis patients with single and multiple nodules admitted from June 2011 to June 2012 in our hospital were selected as the study subjects. All patients were confirmed by operation and pathology. All nodules Ultrasound images of lesions were analyzed, and the diagnosis of the disease to improve the way to be discussed. RESULTS: Of the total patients, 24 had a single nodule, 7 had papillary carcinoma, and 3 had follicular adenocarcinoma; 31 had multiple nodules, 5 had papillary carcinoma, and had follicular glands Tumor in 3 cases, combined with 11 cases of node. Among them, 35 cases were consistent with the pathology, with a diagnostic accuracy of 63.6%, misdiagnosis of 20 cases, 18 cases misdiagnosed as nodular goiter and 2 cases of thyroid cancer with a misdiagnosis rate of 36.4%. Simple Hashimoto’s thyroiditis nodules and thyroid cancer nodules, there are significant differences in the morphology of the nodules, the boundaries with the calcification of the internal morphology and distribution of blood flow signals. CONCLUSIONS: A thorough examination of serological thyroid antibodies and a focus on glandular echogenicity outside the nodules and glandular blood supply should pay particular attention to the presence of irregular nodules with calcifications and blurred borders, suggestive of malignant transformation The possibility, to clinicians with the most valuable tips to improve the overall accuracy of the diagnosis of ultrasound.