摘要
Abstract
Objective To analyze the characteristics of ultrasound images of thyroid cancer and the causes of clinical misdiagnosis,and to summarize the prevention methods of misdiagnosis.Methods Eighty patients with thyroid cancer con-firmed by pathology from February 2021 to February 2024 were retrospectively analyzed,characteristics of their preoperative ultrasound images were analyzed,and the causes of misdiagnosis were summarized.Results A total of 86 malignant nodules were found in these 80 patients.After operation,78 papillary carcinoma,5 follicular carcinoma,2 medullary carcinoma and 1 squamous carcinoma were pathologically confirmed.Eighty-four nodules were diagnosed by ultrasound,the coincidence rate of pathological diagnosis was 72.09%(62/86),the missed diagnosis rate was 2.33%(2/86),and the misdiagnosis rate was 25.58%(22/86).Of the 22 nodules misdiagnosed,16 were misdiagnosed as nodular goiter and6 as adenoma.Pathological examination confirmed 17 papillary carcinoma,4 follicular carcinoma and 1 medullary carcinoma.The ultrasonographic mani-festations of misdiagnosed nodules included 12(54.55%)with clear boundary,9(40.91%)with visible halo,15(68.18%)with low/very low echo,7(31.82%)with microcalcification,and 14(63.64%)with aspect ratio＜1.The misdiagnosed nodular blood supply was mainly grade Ⅰ40.91%and grade 0 27.27%.There were significant differences in boundary,halo sign,low/very low echo,microcalcification,aspect ratio and blood flow grading between misdiagnosed and non-misdiagnosed thyroid nodules(P＜0.05).Conclusion The misdiagnosis rate of ultrasonic diagnosis of thyroid cancer is still at a high level,and some ultrasound images of malignant and benign thyroid nodules are similar.When the ultrasound im-ages of malignant nodules show the characteristics of benign nodules,and the malignant nodules are small and complicated with multiple benign nodules,comprehensive analysis and judgment should be made to reduce misdiagnosis.关键词
甲状腺癌/误诊/超声诊断/图像特点/鉴别诊断/甲状腺结节/甲状腺腺瘤/结节性甲状腺肿Key words
Thyroid cancer/Misdiagnosis/Ultrasonic diagnosis/Image properties/Differential diagnosis/Thyroid nodules/Thyroid adenoma/Nodular goiter分类
医药卫生
