超声影像学检查对甲状腺结节误诊病例研究.docVIP

超声影像学检查对甲状腺结节误诊病例研究[摘要] 目的 对超声影像学检查误诊病例的甲状腺结节声像图特点进行分析研究，旨在进一步提高超声影像学对甲状腺结节的诊断水平。方法 回顾性分析手术后的415例甲状腺结节患者中超声影像学检查误诊的70例患者声像图及病理结果。结果 超声影像学的误诊率为16.9％(70/415)，正确率83.1％(345/415)，全部70例误诊病例中恶性误诊为良性者62例，占88.6％(62/70)。声像图结果显示，71％(44/62)为多发结节，手术病理结果证实在甲状腺癌的同时尚伴有结节性甲状腺肿或腺瘤，其中4例患者有2个癌灶,3例患者有3个癌灶。良性误诊为恶性者8例，占11.4％(8/70)。结论 常规声像图和彩色多普勒技术对甲状腺结节的良恶性鉴别诊断有一定的客观难度，对此要有充分的认识。 [关键词] 甲状腺结节 超声声像图 误诊 鉴别诊断 [中图分类号] R322.5+1[文献标识码] B[文章编号] 1005-0515（2011）-08-319-01 Sonogram of Thyroid Nodules of the Patients Misdiagnosed by Ultrasound Liu Xiaofei (Department of Ultrasound,Traditional Chinese Medical Hospital,Yulin,Shanxi,719000,China) [Abstract] Objective To improve the level of ultrasonic differential diagnosis of thyroid nodules through investi-gating these misdiagnosed sonograms by ultrasound. Methods The sonograms and the patholgical results of 70 Patients misdiagnosed by ultrasound frum 415 patients with thyroid nodules undergoing operation were analyzed retro-sdectively. ResuIts The rate of misdiagnosis was 16.9％(70/415) and the accuracy was 83.1％(345/415).There were 88.6％(62/70) m alignant patients who were misdiagnosed tO be benign．The sonograms showed that 71％(44f/62) multiple nodules,the pathological results of those patients demonstrated thyroid carcinoma accompanied with nodular goiter or adenoma．There were 4 patients who had 2 foci and 3 patients who had 3 foci.There were 11.44％(8/70) benign padents who were misdiagnosed to be m alignant.Conclusions It should be well understood that there exists some difficuity in differentiating benign from m alignant thyroid nodules only through features of sonogram and CDFI technique． [Keywords] Thyroid nodules； Uhrosound sonogram； Misdiagnosis； Differential diagnosis 大约3％至8％无任何症状的成年人有甲状腺结节，而且发生率随年龄增加。随着影像学的广泛应用，甲状腺结节的发现率越来越高[1]。甲状腺的解剖位置表浅、结构均匀，非常适合高频率超声探查，因此，超声影像学已经成为诊断甲状腺结节的重要检查方法，其应用也越来越广泛。本文拟对超声影像学误诊病例的甲状腺结节声像图特点进行分析研究，旨在提高超声影像学对甲状腺结节的诊断水平。 1 资料与方法 1.1 研究对象 2006年2月至2010年12月在我院手术的甲状腺结节患者415例中超声影像学检查误诊的患者70例，男性