A Retrospective Analysis of Ultrasonographic Misdiagnosis of Thyroid Multiple Nodules With Thyroid Carcinoma / 昆明医科大学学报

ABSTRACT

Objectives To explore the ultrasonic features in the differential diagnosis of thyroid multiple nodules with thyroid carcinoma and summarize the causes of misdiagnosis,and to improve the accuracy of ultrasonic diagnosis of thyroid carcinoma.Methods The ultrasound images from the 40 patients with thyroid carcinoma were selected,whose diagnosis of thyroid carcinoma was confirmed by the pathological examinations after surgery but misdiagnosed or not identified by ultrasound examination.These ultrasound images were retrospectively analyzed through observing the carcinomatous nodules in size,aspect ratio,shape,border,envelope,internal echo,calcification characteristics,posterior echo,acoustic halo,the distribution of blood flow,and the relationship with thyroid capsule and anterior organization,whether to transfer to neck or spraclavicular lymph nodes,and the performance of elasticity imaging,and then these features were compared with the ultrasonic features of the benign thyroid nodules.Results The ultrasonic features of thyroid multiple nodules with thyroid carcinoma were complicated and each nodule should be observed and analyzed individually.The ultrasonic features of carcinomatous nodules were(1) irregnlar shape,(2)aspect ratio ≥ 1,(3)unclear border,(4)no capsule,(5)heterogeneous hypo echo inside of the carcinomatous nodules,(6)scattered distribution of clustered microcalcifications,(7)incomplete acoustic halo or absent,(8)blood supply to the centrality inside of the carcinomatous nodules,(9)invaded thyroid capsule and anterior organizations,(10)transformation to neck or supraclavicular lymph nodes in the minority of patients,(11) elasticity imaging score of 3 ～ 5.Conclusions It is quite difficult to identify the ultrasonic features of thyroid multiple nodules with thyroid carcinoma and it is with high misdiagnosis rate.A comprehensive analysis of sonographic features is essential in clinical practices,and it will contribute to improving the accuracy of the ultrasonic diagnosis of thyroid multiple nodules with thyroid carcinoma.