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目的总结原发性甲状腺非霍奇金淋巴瘤(primary thyroid non-Hodgkin lymphoma,PT-NHL)的超声征象。方法回顾性收集四川大学华西医院2002年5月至2014年7月期间收治的、经病理检查证实且具有较完整超声资料的76例PT-NHL患者的超声资料(PT-NHL组),同期收集超声检查怀疑PT-NHL但经病理排除的36例病例作为对照(对照组),分析2组患者超声征象的差异。结果与对照组比较,PT-NHL组的后方回声增强比例较高(P=0.000),甲状腺患侧叶与健侧叶的左右径差、前后径差及上下径差均较大(P<0.05),但2组患者的腺体实质回声、超声表现类型、血流分级及淋巴结情况的差异均无统计学意义(P>0.05)。在结节型患者中(PT-NHL组37例,对照组12例),PT-NHL组的结节直径较大(P=0.000),但2组结节型患者的结节回声、形态、边界及纵横比的差异均无统计学意义(P>0.05);在具有血流频谱数据的患者中(PT-NHL组17例,对照组4例),PT-NHL组的血管阻力指数(RI)较高(P=0.024)。结论后方回声增强是PT-NHL的特征性表现,而甲状腺两侧叶体积不对称、RI升高以及发生较大结节对PT-NHL的诊断具有提示意义;腺体实质回声不均匀伴低回声结节可能是导致误诊为PT-NHL的因素之一。
Objective To summarize the ultrasound signs of primary thyroid non-Hodgkin lymphoma (PT-NHL). Methods We retrospectively collected ultrasound data (PT-NHL group) from 76 patients with PT-NHL confirmed by pathology and having complete ultrasound data from West China Hospital of Sichuan University from May 2002 to July 2014, Thirty-six patients with suspected PT-NHL but pathologically excluded were screened by ultrasound for the control group (control group), and the differences in ultrasound signs between the two groups were analyzed. Results Compared with the control group, the posterior echogenicity was significantly increased in the PT-NHL group (P = 0.000). The differences in left and right diameter, anteroposterior diameter, and anteroposterior diameter of the ipsilateral and contralateral lobes of the thyroid gland were significant (P <0.05 ). However, there was no significant difference in parenchymal echogenicity, sonographic manifestations, grade of blood flow and lymph node between the two groups (P> 0.05). In nodular patients (PT-NHL group, 37 cases, control group, 12 cases), PT-NHL group nodules larger diameter (P = 0.000), but nodular nodules in two groups of patients with nodular echo, (P> 0.05). Among the patients with PT data, there were 17 patients in the PT-NHL group and 4 patients in the control group. The vascular resistance index (RI) in PT-NHL group ) Is higher (P = 0.024). Conclusions The enhancement of posterior echogenicity is the characteristic manifestation of PT-NHL. However, asymmetry of leaf volume on both sides of the thyroid, elevation of RI, and occurrence of larger nodules are of great significance for the diagnosis of PT-NHL. Inhomogeneous hypoechoic echo of the gland Nodules may be one of the factors leading to misdiagnosis as PT-NHL.