甲状腺结节的超声表现与病理特征的相关性分析
发布时间：2019-05-27 19:14
【摘要】：目的 应用彩色多普勒超声仪观察甲状腺良恶性结节的图像特征,结合病理形态学诊断,探讨甲状腺良恶性结节的超声表现与病理学的关系及相关意义,进而提高甲状腺恶性结节的超声诊断符合率。方法 选取110例(125个)甲状腺结节做研究对象,所有病例均行彩色多普勒超声和彩色多普勒超声检查,且均经手术病理证实诊断。其中33例(39个结节)恶性结节,同期选取77例(86个结节)良性结节。通过观察彩色多普勒超声和多普勒超声对125个甲状腺结节所呈现的图像特征,统计各超声图像对甲状腺恶性结节的诊断敏感度和特异度,比较各超声图像对甲状腺结节良恶性鉴别的意义；比对分析这33例(39个结节)恶性结节的HE病理切片,提供病理形态学依据。结果 甲状腺恶性结节与结节的多发或单发无明显关系。甲状腺恶性结节彩色多普勒超声图像显示：实性结节(100%)、边界模糊(76.90%)、形态不规则(59.00%)、周边无晕环(92.30%)、回声不均(94.90%)、低回声(94.90%),内部见微钙化(69.20%),颈部淋巴结肿大(41.00%)；多普勒超声显示以内部血流信号为主(74.40%)。各超声图像对甲状腺结节的良恶性诊断均提示有统计学意义(P0.05)。甲状腺恶性结节病理切片显示：切面呈灰白色,质地坚硬；低倍镜下显示形态多不规则(22/39),边界多模糊(30/39),纤维假包膜(10/39)；砂粒体数目多≥5个/HP(26/39),病灶内组织由癌细胞(分为滤泡状和乳头状两种)和纤维间质组成。不同的病灶,组织细胞所占的比例也有所不同；纤维间质均有程度不等的玻璃样变；癌细胞与纤维间质呈带状排列或交错排列。结论 1超声影像检查对甲状腺结节检出率高。二维超声及彩色多普勒超声表现有助于甲状腺结节性质的判断。 2甲状腺结节表现为：形态不规则、边界模糊、内部低回声伴有微小钙化灶、颈部淋巴结肿大并且声像异常则恶性病变可能性增大。 3甲状腺恶性结节的超声表现及彩色多普勒特点与病理学分型密切相关。
[Abstract]:Objective to observe the image features of benign and malignant thyroid nodules by color Doppler ultrasound, and to explore the relationship between ultrasonic findings and pathology of benign and malignant thyroid nodules and its significance combined with pathomorphological diagnosis. Thus, the coincidence rate of ultrasonic diagnosis of malignant thyroid nodules was improved. Methods 110 cases (125 thyroid nodules) were studied. All cases were examined by color Doppler ultrasound and color Doppler ultrasound, and all of them were confirmed by operation and pathology. Among them, 33 cases (39 nodules) were malignant nodules, 77 cases (86 nodules) benign nodules were selected at the same time. By observing the imaging features of 125 thyroid nodules by color Doppler ultrasound and Doppler ultrasound, the sensitivity and specificity of each ultrasound image in the diagnosis of thyroid malignant nodules were counted. To compare the significance of ultrasound images in the differential diagnosis of benign and malignant thyroid nodules. The HE pathological sections of 33 cases (39 nodules) of malignant nodules were compared and analyzed to provide pathomorphological basis. Results there was no significant relationship between malignant thyroid nodules and multiple or single nodules. Color Doppler ultrasound images of malignant thyroid nodules showed solid nodules (100%), blurred boundaries (76.90%), irregular morphology (59.00%), no halo ring around (92.30%) and uneven echo (94.90%). Hypoechoic (94.90%), microcalcification (6920%) and cervical lymph node enlargement (41.00%). Doppler ultrasound showed the main internal blood flow signal (74.40%). All ultrasound images showed statistical significance in the diagnosis of benign and malignant thyroid nodules (P 0.05). The pathological sections of malignant thyroid nodules showed that the section was grayish white and hard, the shape was irregular (22 鈮，
本文编号：2486415
[Abstract]:Objective to observe the image features of benign and malignant thyroid nodules by color Doppler ultrasound, and to explore the relationship between ultrasonic findings and pathology of benign and malignant thyroid nodules and its significance combined with pathomorphological diagnosis. Thus, the coincidence rate of ultrasonic diagnosis of malignant thyroid nodules was improved. Methods 110 cases (125 thyroid nodules) were studied. All cases were examined by color Doppler ultrasound and color Doppler ultrasound, and all of them were confirmed by operation and pathology. Among them, 33 cases (39 nodules) were malignant nodules, 77 cases (86 nodules) benign nodules were selected at the same time. By observing the imaging features of 125 thyroid nodules by color Doppler ultrasound and Doppler ultrasound, the sensitivity and specificity of each ultrasound image in the diagnosis of thyroid malignant nodules were counted. To compare the significance of ultrasound images in the differential diagnosis of benign and malignant thyroid nodules. The HE pathological sections of 33 cases (39 nodules) of malignant nodules were compared and analyzed to provide pathomorphological basis. Results there was no significant relationship between malignant thyroid nodules and multiple or single nodules. Color Doppler ultrasound images of malignant thyroid nodules showed solid nodules (100%), blurred boundaries (76.90%), irregular morphology (59.00%), no halo ring around (92.30%) and uneven echo (94.90%). Hypoechoic (94.90%), microcalcification (6920%) and cervical lymph node enlargement (41.00%). Doppler ultrasound showed the main internal blood flow signal (74.40%). All ultrasound images showed statistical significance in the diagnosis of benign and malignant thyroid nodules (P 0.05). The pathological sections of malignant thyroid nodules showed that the section was grayish white and hard, the shape was irregular (22 鈮，
本文编号：2486415
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