桥本甲状腺炎背景下甲状腺结节的超声诊断
Ultrasonographic Features of Thyroid Nodules Accompanied by Hashimoto Thyroiditis
查看参考文献23篇
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文摘
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目的比较桥本甲状腺炎(HT)背景下甲状腺良恶性结节的超声影像学特征。方法以2013年1月至12月在北京协和医院经手术病理证实的伴HT良、恶性甲状腺结节连续病例各60例为研究对象,分析比较了其术前超声影像学特征。结果60例恶性结节中,60例(100.0%)为甲状腺乳头状癌。60例良性结节中,33例(55.0%)为桥本结节样改变,26例(43.3%)为结节性甲状腺肿,1例(1.7%)为腺瘤。与良性结节相比,恶性结节更多表现为实性(91.7%比68.3%,P=0.001)、低回声(96.7%比48.3%,P=0.000)、边界不清(95.0%比41.7%,P=0.000)、形态不规则(96.7%比43.4%,P=0.000)、微钙化(71.7%比30.0%,P=0.000)、缺乏规则晕(96.7%比65.0%,P=0.000)、纵横比≥1(46.7%比13.3%,P=0.000)、血流局部丰富或不规则(61.7%比26.7%,P=0.000)。结论超声对于伴HT的甲状腺结节良恶性鉴别的总体敏感性理想。实性结构、实性成分回声水平低、边界不清晰、形态不规则、缺乏规则晕是较好的筛查指标。除纵横比≥1外,其他指标的诊断特异性均不理想。 |
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其他语种文摘
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Objective To compare the ultrasound imaging characteristics of benign and malignant thyroid nodules on the background of Hashimoto’s thyroiditis (HT). Methods Totally 120 consecutive patients with pathologically confirmed benign (n = 60) or malignant (n = 60) thyroid nodules in Peking Union Medical College Hospital since January 2013 were retrospectively analyzed,and their preoperative ultrasound images were reviewed. Results Sixty cases (100%) of the malignant nodules were papillary thyroid cancers. In the benign group,33 cases (55. 0%) had nodular changes of HT,26 (43. 3%) had nodular goiter,and one (16. 7%) had adenoma. Compared with the benign ones,the malignant nodules were more likely to be solid (91. 7% vs. 68. 3%,P = 0. 001),hypoechoic (96. 7% vs. 48. 3%,P = 0. 000),ill defined (95. 0% vs. 41. 7%,P =0. 000),irregular (96. 7% vs. 43. 4%,P = 0. 000),and more easily to have such characteristics as microcalcification(71. 7% vs. 30. 0%,P = 0. 000),absence of regular halo (96. 7% vs. 65. 0%,P = 0. 000), taller-than-wide sign (46. 7% vs. 13. 3%,P = 0. 000),and locally increased or irregular blood flow (61. 7% vs. 26. 7%,P = 0. 000). Conclusions Ultrasound has an ideal overall sensitivity in differentiating nodules on the background of HT. Solid structure,hypo-echogenicity,ill-defined margin,irregular shape,and absence of regular halo are good screening ultrasound markers. Except for the A/T≥1,the other variables have less satisfactory diagnostic specificity. |
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来源
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中国医学科学院学报
,2014,36(3):261-266 【核心库】
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DOI
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10.3881/j.issn.1000-503x.2014.03.006
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关键词
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桥本甲状腺炎
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甲状腺乳头状癌
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超声检查
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地址
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中国医学科学院北京协和医学院北京协和医院超声医学科, 北京, 100730
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1000-503X |
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学科
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临床医学;肿瘤学 |
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基金
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国家自然科学基金
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文献收藏号
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CSCD:5231882
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参考文献 共
23
共2页
|
|
1.
Caturegli P. Hashimoto thyroiditis: clinical and diagnostic criteria.
Autoimmun Rev,2014,13(4/5):391-397
|
被引
41
次
|
|
|
|
|
2.
Teng W. Effect of iodine intake on thyroid diseases in China.
N Engl J Med,2006,354(26):2783-2793
|
被引
117
次
|
|
|
|
|
3.
Teng X. More than adequate iodine intake may increase subclinical hypothyroidism and autoimmune thyroiditis: a cross-sectional study based on two Chinese communities with different iodine intake levels.
Eur J Endocrinol,2011,164(6):943-950
|
被引
11
次
|
|
|
|
|
4.
Konturek A. Coexistence of papillary thyroid cancer with Hashimoto thyroiditis.
Langenbecks Arch Surg,2013,398(3):389-394
|
被引
13
次
|
|
|
|
|
5.
Chen Y K. Cancer risk in patients with Hashimoto's thyroiditis: a nationwide cohort study.
Br J Cancer,2013,109(9):2496-2501
|
被引
7
次
|
|
|
|
|
6.
Kwak J Y. Image reporting and characterization system for ultrasound features of thyroid nodules: multicentric Korean retrospective study.
Korean J Radiol,2013,14(1):110-117
|
被引
15
次
|
|
|
|
|
7.
张波. 甲状腺结节的超声诊断思维.
中华超声影像学杂志,2011,20(8):726-728
|
被引
7
次
|
|
|
|
|
8.
American Thyroid Association Guidelines Taskforce on Thyroid N. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
Thyroid,2009,19(11):1167-1214
|
被引
419
次
|
|
|
|
|
9.
Kim K W. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis.
Head Neck,2011,33(5):691-695
|
被引
14
次
|
|
|
|
|
10.
Fiore E. Hashimoto's thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine.
Endocr Relat Cancer,2011,18(4):429-437
|
被引
13
次
|
|
|
|
|
11.
Haymart M R. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage.
J Clin Endocrinol Metab,2008,93(3):809-814
|
被引
35
次
|
|
|
|
|
12.
Gharib H. Changing concepts in the diagnosis and management of thyroid nodules.
Endocrinol Metab Clin North Am,1997,26(4):777-800
|
被引
11
次
|
|
|
|
|
13.
Frates M C. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography.
J Clin Endocrinol Metab,2006,91(9):3411-3417
|
被引
38
次
|
|
|
|
|
14.
Campos L A. Thyroid papillary carcinoma associated to Hashimoto's thyroiditis.
Braz J Otorhinolaryngol,2012,78(6):77-80
|
被引
4
次
|
|
|
|
|
15.
Ahn D. Clinical relationship between Hashimoto's thyroiditis and papillary thyroid cancer.
Acta Oncol,2011,50(8):1228-1234
|
被引
10
次
|
|
|
|
|
16.
Kim E Y. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma.
Clin Endocrinol(Oxf),2009,71(4):581-586
|
被引
18
次
|
|
|
|
|
17.
McManus C. Is thyroidectomy in patients with Hashimoto thyroiditis more risky.
J Surg Res,2012,178(2):529-532
|
被引
2
次
|
|
|
|
|
18.
Yildirim D. Nodule or pseudonodule? Differentiation in Hashimoto's thyroiditis with sonoelastography.
J Int Med Res,2011,39(6):2360-2369
|
被引
3
次
|
|
|
|
|
19.
Anderson L. Hashimoto thyroiditis: Part 1,sonographic analysis of the nodular form of Hashimoto thyroiditis.
AJR Am J Roentgenol,2010,195(1):208-215
|
被引
26
次
|
|
|
|
|
20.
Anderson L. Hashimoto thyroiditis: Part 2,sonographic analysis of benign and malignant nodules in patients with diffuse Hashimoto thyroiditis.
AJR Am J Roentgenol,2010,195(1):216-222
|
被引
26
次
|
|
|
|
|
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