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甲状腺结节的超声诊断及治疗

姜玉新 张波

姜玉新, 张波. 甲状腺结节的超声诊断及治疗[J]. 协和医学杂志, 2010, 1(1): 34-39.
引用本文: 姜玉新, 张波. 甲状腺结节的超声诊断及治疗[J]. 协和医学杂志, 2010, 1(1): 34-39.

甲状腺结节的超声诊断及治疗

详细信息
    通讯作者:

    姜玉新电话:010-65295491, E-mail:yuxinjiangxh@yahoo.com.cn

  • 中图分类号: R736.1;R445.1

  • 图  1  女, 43岁, 体检发现甲状腺结节2个月, 超声提示甲状腺右叶恶性结节(白箭头)

    A.灰阶超声显示甲状腺右叶上中部低回声1. 2 c m× 1. 3 c m, 边界不规则, 纵横比> 1;B.彩超显示血流信号较丰富、杂乱病理诊断为甲状腺乳头状癌

    图  2  女, 46岁, 咽部不适半年, 超声提示甲状腺左叶恶性结节(白箭头)

    A.灰阶超声显示甲状腺左叶下极低回声1. 0 c m× 1. 3 c m, 形态不规则, 内部可见多个点状强回声; B.超声造影显示不均匀增强病理诊断为甲状腺乳头状癌

    表  1  预示恶性甲状腺结节超声特征的敏感性和特异性(%) [9]

    超声特征 敏感性(范围) 特异性(范围)
    低回声 53. 4 (26. 5~ 87. 1) 73. 2 (43. 4~ 94. 3)
    微钙化 42. 3 (29. 0~ 59. 2) 91. 2 (85. 5~ 95. 0)
    不规则边界 57. 7 (47. 8~ 77. 5) 85.1 (74. 3~ 95. 3)
    纵横比>1 58. 1 (32. 7~ 83. 6) 81. 4 (60. 0~ 92. 5)
    缺乏晕 63. 6 (32. 5~ 88. 9) 61. 2 (22. 2~ 80. 0)
    多普勒信号增多 77. 2 (56. 7~ 92. 3) 79. 3 (34. 7~ 97. 4)
    下载: 导出CSV

    表  2  甲状腺结节的FNA超声指征[8]及推荐级别

    甲状腺结节的FNA超声指征 推荐级别
    高危人群5~ 9mm结节具有可疑超声特征 A
    不正常的颈部淋巴结 A
    ≥1c m的结节具有微钙化 B
    ≥1c m实性低回声结节 B
    ≥1~ 1. 5c m实性和等回声或高回声结节 B
    ≥1. 5~ 2. 0cm混合囊性/实性结节具有可疑的超声特征 B
    ≥2c m囊性为主或海绵样结节无可疑超声特征 C
    A:证据明确, 强烈推荐; B:证据中等, 推荐; C:专家推荐
    下载: 导出CSV
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出版历程
  • 收稿日期:  2010-04-01
  • 刊出日期:  2010-07-30

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