摘要
目的:应用超声对桥本甲状腺炎合并甲状腺癌的特点进行评估,并对甲状腺癌在不同甲状腺功能状态下的超声特点进行分析。方法:回顾性分析2016年8月—2018年11月在于河北省人民医院诊断为桥本甲状腺炎合并甲状腺结节的80例患者(86个结节),所有结节经细针穿刺或手术病理诊断。根据病理结果分组,分析甲状腺癌的超声特征。按不同甲状腺功能分组,比较甲状腺功能正常组、甲减组、甲亢组的桥本甲状腺炎合并甲状腺癌的超声特征。结果:桥本甲状腺炎背景下甲状腺良性结节44例(良性组),甲状腺癌42例(恶性组),良恶性组结节在回声、形态、边界、纵横比、钙化情况方面差异有统计学意义(P<0.05)。甲减组与正常组、甲亢组比较,桥本甲状腺炎背景下恶性甲状腺结节钙化差异有统计学意义(P<0.05),甲减组合并局灶性钙化征象恶性占比大。结论:低回声、形态不规则、边界不清晰、纵横比≥1、局灶性钙化是超声诊断桥本伴甲状腺恶性结节的重要特征,甲状腺功能减低合并局灶性钙化时应高度怀疑恶性。
Objective Assess the characteristics of Hashimoto thyroiditis combined with thyroid cancer using ultrasound,and analyze the ultrasound characteristics of thyroid cancer nodules in different states of thyroid function.Methods A retrospective analysis of 80 patients(86 nodules)diagnosed with Hashimoto thyroiditis combined with thyroid nodules who visited the Hebei General Hospital from August 2016 to November 2018.All nodules were judged for benign or malignant nature through fine-needle aspiration or surgical pathology.Based on the pathological results,the ultrasound characteristics of thyroid cancer were analyzed.The ultrasound characteristics of Hashimoto thyroiditis combined with thyroid cancer were compared among groups with normal thyroid function,hypothyroidism,and hyperthyroidism.Results In the context of Hashimoto thyroiditis,there were 44 cases of patients with benign thyroid nodules(benign group)and 42 cases of thyroid cancer patients(malignant group).There were statistically significant differences in echogenicity,shape,margin,axial ratio,and calcification between the benign and malignant groups(P<0.05).When compared the hypothyroid group with the normal and hyperthyroid groups,there were statistically significant differences in the calcification of thyroid cancer nodules in the context of Hashimoto thyroiditis(P<0.05),with a higher rate of malignancy associated with focal calcification signs in the hypothyroid group.Conclusion Hypoechoic,irregular shape,ill-defined margins,axial ratio≥1,and focal calcification are important characteristics in the ultrasound diagnosis of malignant thyroid nodules associated with Hashimoto thyroiditis.A high index of suspicion for malignancy is warranted when hypothyroidism is combined with focal calcifications.
作者
丁金
孙兆莲
薛静莉
DING Jin;SUN Zhaolian;XUE Jingli(Department of Functional Diagnostics,Changping District Integrated Traditional Chinese and Western Medicine Hospital,Beijing 102200,China;Department of Ultrasound,Hebei General Hospital,Shijiazhuang,Hebei 050000,China)
出处
《影像研究与医学应用》
2024年第19期17-20,共4页
Journal of Imaging Research and Medical Applications
关键词
桥本甲状腺炎
甲状腺癌
超声诊断
甲状腺功能
Hashimoto thyroiditis
Thyroid cancer
Ultrasonic diagnosis
Thyroid function
