摘要
目的对异位甲状腺的彩色多普勒超声误诊情况及原因进行分析。方法选取我院收治的异位甲状腺患者48例,使用彩色多普勒超声诊断仪进行诊断,并对48例患者的临床及病理诊断结果进行分析,同时对超声诊断异位甲状腺患者和误诊患者的声像图特点进行分析。结果48例异位甲状腺患者中,在甲状腺区未发现甲状腺组织42例(88%),发现甲状腺组织存在6例(12%),发现合并并发症患者20例(42%),超声诊断与病理检查和穿刺活检检查结果一致者39例,诊断准确率为81%,其中9例(19%)发生误诊。异位甲状腺的超声声像图特点如下:异位甲状腺位置、大小均差别较大,异位甲状腺的大小为(1.7 cm×1.1 cm)^(5.1 cm×2.8 cm);异位甲状腺的边界均表现为清晰,36例(75%)内部结构为实性,12例(25%)为囊实性;异位甲状腺的形态可呈现椭圆、圆形等规则性变化;回声分布,19例(40%)呈现混合回声,18例(38%)呈现中等回声,11例(23%)呈现低回声;血流信号34例(71%)较为丰富,14例(29%)在内部呈现点条状、较为稀疏的血流信号。结论彩色多普勒超声诊断异位甲状腺的准确率较高,且无辐射,操作较为简便,然而仍然存在误诊的情况,超声医师应对可能存在异位甲状腺的患者扩大检查范围,并注意与甲状舌管囊肿、肿大淋巴结等超声图像的区分,必要时使用穿刺活检、CT等进行辅助检查,以降低误诊率。
Objective To analyze the misdiagnosis and causes of color Doppler ultrasound in ectopic thyroid gland.Methods Forty eight cases of ectopic thyroid patients admitted to our hospital were selected and diagnosed by color Doppler ultrasound.The clinical and pathological diagnosis results of 48 patients were analyzed,and the sonographic features of patients with ectopic thyroid and misdiagnosed patients were analyzed.Results Of the 48 patients with ectopic thyroid,42(88%)had no thyroid tissue found in the thyroid region,and 6(12%)had thyroid tissue.Twenty patients(42%)with complications were diagnosed.Ultrasound diagnosis was consistent with pathological examination and biopsy results in 39 cases(81%),and 9 cases(19%)were misdiagnosed.The sonographic features of the ectopic thyroid gland are as follows:the location and size of the ectopic thyroid are quite different,and the size of the ectopic thyroid is(1.7 cm×1.1 cm)-(5.1 cm×2.8 cm);the borders of ectopic thyroid were clear,36(75%)were solid,and 12(25%)were cystic;The morphology of the ectopic thyroid can exhibit regular changes such as ellipse and circle;In the echo distribution,19 cases(40%)showed mixed echoes,18 cases(38%)showed moderate echoes,and 11 cases(23%)showed low echoes;Blood flow signals were abundant in 34 cases(71%),and 14 cases(29%)showed a strip-like,sparse blood flow signal inside.Conclusion Doppler color ultrasound is more accurate in the diagnosis of ectopic thyroid gland,and it has no radiation,easy to operate,but there are still misdiagnosis cases.The sonographer should expand the scope of the examination for patients with ectopic thyroid gland,and pay attention to the distinction between ultrasound images such as thyroglossal cysts and enlarged lymph nodes.If necessary,use a needle biopsy or CT to perform an auxiliary examination to reduce the rate of misdiagnosis.
作者
黎静
金学蔚
Li Jing;Jin Xuewei(Functional Department of Shaanxi Province Nuclear Industry 215 Hospital,Xianyang 712000,China)
出处
《山西医药杂志》
CAS
2019年第23期2873-2875,共3页
Shanxi Medical Journal
关键词
异位甲状腺
超声
误诊
Ectopic thyroid
Ultrasound
Misdiagnosis
