| 邹道远,武心萍,丁文波,张于芝.甲状腺术后缝线肉芽肿超声图像分析[J].中国医学影像技术,2020,36(1): |
| 甲状腺术后缝线肉芽肿超声图像分析 |
| Analysis of ultrasound features of suture granulomas in thyroid after surgery |
| 投稿时间：2019-03-14 修订日期：2020-01-06 |
| DOI： |
| 中文关键词: 甲状腺 缝线肉芽肿 超声诊断 细针穿刺细胞学 |
| 英文关键词:Thyroid Suture granulomas Ultrasonic diagnosis Fine needle aspiration cytology |
| 基金项目:江苏省中医药局科技项目基金 |
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| 中文摘要: |
| 摘 要 目的 分析甲状腺术后患者颈部手术缝线刺激形成的异物肉芽肿的超声表现，以提高甲状腺术后结节超声诊断的准确率，减少不必要的穿刺或重复手术。方法 回顾性分析2015年10月-2018年3月至我院超声科就诊的甲状腺全切术或部分切除术后患者，挑选颈部结节经超声检查、细针穿刺细胞学检查及临床观察诊断为手术缝线异物肉芽肿者，分析其超声声像图特征性改变。结果 最终共47名患者（86枚颈部肉芽肿结节）纳入研究。本研究入选的86枚肉芽肿结节均分布于甲状腺残端边缘或手术区软组织内，均表现为低回声结节，无包膜，形态呈多样，边缘不规则，其内均见多发性点状强回声，后方多伴有声影。所有结节中80例显示血流信号稀少（93.02%），6例血流丰富（6.98%）。经弹性超声检查，弹性评分2级者占27.91%（24/86例），3级者27.91%（24/86例），4级者44.19%（38/86例）。结论 甲状腺术后缝线肉芽肿超声声像图具有特征性改变，多表现为甲状腺残端或周围颈部软组织内的不规则低回声，内部伴集中于结节中心的点状强回声，以此可与甲状腺恶性病变相鉴别。 |
| 英文摘要: |
| [Abstract] Objective To analyze the ultrasonic manifestations of foreign body granulomas induced by suture stimulation in patients after thyroid surgery, so as to improve the diagnostic accuracy of thyroid nodules after surgery, and to avoid unnecessary biopsy and reoperation. Methods Retrospective analysis was performed on patients admitted to the ultrasound department of our hospital from October 2015 to March 2018 after total thyroidectomy or partial thyroidectomy. Analyze the characteristic changes of ultrasound images whose neck nodules were diagnosed as surgical suture foreign body granuloma by ultrasonography, fine needle puncture cytology and clinical observation.Results A total of 47 patients (86 neck granulomatous nodules) were included in the study. All of the 86 suture granuloma nodules were located in the margin of the residual thyroid gland or in the soft tissue around the surgical region. The ultrasound characteristics of these granulomas were hypoechoic nodules without capsule, with irregular margin and punctate echogenic foci followed by some degree of acoustic shadowing. The color Doppler ultrasound showed that the blood flow signals were scarce in 80 nodules (93%) and abundant in 6 nodules (7%). Elastography score was assessed for each nodule, 29%(25/86) of the nodules were assessed as grade 2, 29%(25/86) were grade 3, and 42%(36/86) were grade 4. Conclusion Ultrasonography of suture granuloma after thyroid surgery has characteristic changes, which are mainly manifested as irregular hypoechoic in thyroid residual or surrounding neck soft tissue, with internal spot-like strong echo concentrated in the center of nodules, which can be differentiated from thyroid malignant disease. |
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