本文選題：甲狀腺結(jié)節(jié)　切入點(diǎn)：超聲　出處：《中國老年學(xué)雜志》2016年12期

【摘要】：目的從病理學(xué)角度探討具有可疑超聲特征的老年甲狀腺良性結(jié)節(jié)術(shù)前誤診原因。方法選取老年甲狀腺良性結(jié)節(jié)患者355例,其中術(shù)前超聲誤診為甲狀腺癌22例(29個結(jié)節(jié)),收集術(shù)前超聲聲像圖,術(shù)中取甲狀腺結(jié)節(jié)組織,術(shù)后復(fù)查病理切片,分析超聲誤診病例的超聲和病理表現(xiàn)。結(jié)果甲狀腺結(jié)節(jié)最大徑≤10 mm組內(nèi)部結(jié)構(gòu)為實(shí)性、極低回聲、縱橫比1的比例明顯高于最大徑10 mm組,鈣化率明顯低于最大徑10 mm組(P0.05);29個術(shù)前超聲誤診甲狀腺結(jié)節(jié)術(shù)后病理診斷:結(jié)節(jié)性甲狀腺腫19例(27個結(jié)節(jié)),非典型腺瘤2例(2個結(jié)節(jié)),亞急性甲狀腺炎1例(無具體結(jié)節(jié));可疑征象的甲狀腺良性結(jié)節(jié)中主要病理表現(xiàn)為廣泛纖維化伴玻璃樣變、鈣化,出現(xiàn)比例明顯高于濃縮膠質(zhì)、骨化生等另外6種病理表現(xiàn)(P0.01)。結(jié)論老年結(jié)節(jié)性甲狀腺結(jié)節(jié)在退行性變中可能出現(xiàn)可疑超聲征象,其病理基礎(chǔ)為結(jié)節(jié)內(nèi)廣泛纖維化、鈣化。
[Abstract]:From the view of pathology objective to explore the causes of misdiagnosis of senile benign thyroid nodules in patients with suspicious sonographic features. Methods 355 cases of elderly patients with benign thyroid nodules, 22 cases of thyroid cancer among preoperative misdiagnosis (29 nodules), preoperative ultrasonography, and thyroid nodule tissue during surgery, postoperative pathology analysis of ultrasound and pathology biopsy, ultrasound misdiagnosed cases of thyroid nodules. The maximum diameter of less than 10 mm group internal structure is solid, the extremely low echo, the aspect ratio of 1 was significantly higher than the proportion of the maximum diameter of 10 mm group, calcification rate was significantly lower than the maximum diameter of 10 mm group (P0.05); 29 preoperative ultrasound misdiagnosis thyroid nodules in the postoperative pathological diagnosis: 19 cases of nodular goiter (27 nodules), 2 cases of atypical adenoma (2 nodules), 1 cases of subacute thyroiditis (no specific nodules); the main pathological thyroid benign nodules showed signs of suspicious Extensive fibrosis and hyalinization, calcification, appeared significantly higher than the proportion of concentrated colloid, osseous metaplasia further 6 pathology (P0.01). Conclusion the elderly nodular thyroid nodules may appear suspicious sonographic signs of degeneration, the pathological basis for extensive fibrosis nodules, calcification.

【作者單位】： 鄭州市骨科醫(yī)院;
【基金】：河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目(No.2014ZC01014)
【分類號】：R445.1;R581

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