摘要
目的:探讨甲状腺出血性囊性结构的临床及超声特征.方法:回顾性分析 2014 年 1 月—2023 年 8 月我院超声诊断科经超声介入微创治疗的甲状腺出血性囊性结构,共 496 例,统计分析其诱因、临床症状和体征、甲状腺功能以及超声表现.结果:在 496 例患者中有诱因者 483 例(97.38%),其中咳嗽喷嚏和恶心呕吐 352 例(70.97%).突然颈部胀痛者 451 例(90.93%).甲状腺球蛋白升高 406 例(81.85%).超声检查 85.48%囊性结构内可见点状低回声漂浮物,75.60%可见点状低回声游动及沉降现象.结论:甲状腺出血性囊性结构多有诱因,可突然引起甲状腺内静脉压力增大的因素是常见的诱因;颈部突然胀痛是发病初期典型的临床表现;甲状腺球蛋白升高是主要甲状腺功能异常的指标;点状低回声漂浮物以及游动或沉降现象是典型的超声表现.综合诱因、临床症状体征、甲状腺功能及超声表现可以诊断甲状腺出血性囊性结构.
Abstract
Objective:To investigate the clinical and ultrasonic features of the hemorrhagic cystic structure in the thyroid.Methods:From January 2014 to August 2023,496 cases of thyroid hemorrhagic cystic structures underwent minimally inva-sive ultrasound intervention in the Ultrasonic Diagnosis Department of the Eastern Theater Command General Hospital were retrospectively analyzed,and their inducement,clinical symptoms and signs,thyroid function and ultrasonic manifestations were statistically analyzed.Results:Among 496 patients,483 had inducement,accounting for 97.38%,including 352 cases(70.97%)of coughing,sneezing,nausea and vomiting.There were 451 cases with sudden neck distension,accounting for 90.93%.Thy-roid globulin increased in 406 cases,accounting for 81.85%.By ultrasonography,85.48%of the cystic structures could see the spot hypoechoic flotsam,75.60%could see the spot hypoechoic swimming and sedimentation phenomenon.Conclusion:There are often inducements in the thyroid hemorrhagic cystic structures,and the factors that can cause the sudden increase of internal thyroid vein pressure are common causes.The sudden swelling and pain of the neck is the typical clinical mani-festation in the early stage of the disease.Thyroglobulin elevation is the main indicator of thyroid dysfunction.Spot hypoechoic flotsam and swimming or sedimentation phenomenon are typical ultrasonic manifestations.Combined causes,clinical symptoms and signs,thyroid function and ultrasound findings can diagnose the hemorrhagic cystic structure of the thyroid.