原发性甲状腺淋巴瘤12例超声征象分析
Ultrasound signs of 12 cases of primary thyroid lymphoma
目的 探讨原发性甲状腺淋巴瘤的超声征象,以提高超声医师对该病诊断的准确率.方法 回顾性分析2013年1月至2018年3月在郑州大学附属肿瘤医院经活检穿刺或手术病理证实为原发性甲状腺淋巴瘤(PTL)12例患者的超声声像图,结合ACR-TIRADS指南,对病变的形态、结构、边缘、内回声水平、局灶性强回声、彩色多普勒血流、后方回声水平、颈部淋巴结回声特征等超声征象进行分析.结果 二维超声结果显示,PTL大多表现为甲状腺双侧叶弥漫性体积增大或单侧叶体积增大,其中双侧叶病变3例(25.0%),单侧叶病变9例(75.0%);结节纵横比值<1者12例(100.0%);声像图中结构呈实性者9例(75.0%),混合性者3例(25.0%);边缘征象光滑者5例(41.7%),模糊者7例(58.3%);内回声呈低回声者12例(100.0%);内可见局灶性强回声者1例(8.3%),内未见局灶性强回声者11例(91.7%);结节内血流丰富者10例(83.3%),可见血流信号者2例(16.7%);所有结节后方回声均增强;其中有9例伴有颈部肿大淋巴结.结论 PTL声像图有一定的特征,超声医师在检查中遇到较典型的超声征象时,应考虑到甲状腺淋巴瘤的可能.
更多Objective To investigate the ultrasound signs of primary thyroid lymphoma, so as to improve the accuracy of the diagnosis by ultrasound physician. Methods Ultrasound images of 12 patients with primary thyroid lymphoma ( PTL) confirmed by biopsy or surgical pathology from January 2013 to March 2018 at the Affiliated Tumor Hospital of Zhengzhou University were retrospectively analyzed. And ultrasound signs such as morphology, structure, margin, internal echo level, focal strong echo, color Doppler flow, posterior echo level, and cervical lymph node echo characteristics of the 12 patients were analyzed according to ACR-TIRADS guidelines. Results In two-dimensional ultrasound examination, most of the PTL showed diffuse volume of the bilateral thyroid or increased unilateral leaf volume, including 3 cases (25. 0%) of bilateral lobe lesions and 9 cases (75. 0%) of unilateral lobe lesions. There were 12 cases (100. 0%) with nodular aspect ratio <1, 9 cases (75. 0%) with solid structure in the sonogram, 3 cases ( 25. 0%) with mixed type. There were 5 cases ( 41. 7%) with smooth edge signs, and 7 cases ( 58. 3%) with ambiguity edge signs. Twelve cases ( 100. 0%) were with hypoechoic internal echo, and 1 case (8. 3%) was with focal strong echoes and 11 cases were with focal strong echoes ( 91. 7%) . Abundant blood flows in the nodules were presented in 10 cases (83. 3%) , and 2 cases ( 16. 7%) had blood flow signals; all echoes in the posterior nodules were enhanced; 9 cases were associated with cervical lymph nodes. Conclusions PTL sonograms have certain characteristics. When the sonographer encounters typical ultrasound signs during the examination, the possibility of thyroid lymphoma should be considered.
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