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目的:对结节性甲状腺肿并甲状腺癌误诊的4例病例进行回顾性分析。方法:选取2009年1月至2012年3月在广州市越秀区六榕街社区卫生服务中心检查甲状腺癌被误诊为甲状腺肿肿及甲状腺腺瘤的患者4例。所有患者在手术前都通过甲状腺超声进行诊断,并被术后病理检查后完全确诊其为甲状腺癌。对造成4例病例出现误诊的原因进行排查与分析。结果:甲状腺超声误诊有1例甲状腺腺瘤,3例结节性甲状腺肿,其主要原因为误诊的结节边界多清晰,并有一定的晕光反应,再加之存在少量的钙化以及合并多发良性结节情况,以及临床出现较多误诊的情形。结论:在对结节性甲状腺肿并甲状腺癌进行超声诊断时,如遇小病灶需进行更为仔细的检查,从边界、形态、病灶血流、淋巴结、声晕以及回声等方面,对诊断结果进行佐证,必要时可进一步结合弹性成像,尽可能避免临床漏诊与误诊。
Objective: To retrospectively analyze 4 cases of misdiagnosis of nodular goiter and thyroid cancer. Methods: From January 2009 to March 2012 in Yuexiu District of Guangzhou Liu Rong Street Community Health Center check thyroid cancer was misdiagnosed as goiter and thyroid adenoma patients 4 cases. All patients were diagnosed by thyroid ultrasound before surgery and were completely diagnosed as thyroid cancer after the pathological examination. Causes and causes of misdiagnosis in 4 cases were investigated and analyzed. Results: One case of thyroid adenoma and three cases of nodular goiter misdiagnosed by thyroid ultrasonography were mainly due to the more clear misdiagnosis of the nodule border and the certain corona reaction, combined with the presence of a small amount of calcification and the combination of multiple benign Nodules, as well as clinical misdiagnosis. CONCLUSIONS: In the diagnosis of nodular goiter and thyroid cancer, ultrasonographic diagnosis of small lesions requires more careful examination. From the aspects of boundary, morphology, focal blood flow, lymph nodes, dizziness and echogenicity, the diagnostic results Evidence, if necessary, can be further combined with elastography, as far as possible to avoid clinical misdiagnosis and misdiagnosis.