Kwak Jin Young, Kim Eun-Kyung, Kim Min Jung, Son Eunju
Department of Diagnostic Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, Korea.
J Clin Ultrasound. 2009 May;37(4):189-93. doi: 10.1002/jcu.20566.
To evaluate the sonographic features of traumatic neuromas after neck dissection.
This study included 8 patients whose ages ranged from 36-69 years (mean, 49 years). In all cases, traumatic neuromas were incidentally detected at neck sonography for evaluation of suspected recurrence of well-differentiated papillary carcinoma of the thyroid. All sonograms and medical records were retrospectively reviewed.
This study covered 8 cases in which traumatic neuromas were diagnosed by clinical, laboratory, fine-needle aspiration biopsy (FNAB), and other imaging modalities. None of the patients had clinical signs of neuromas, which were, incidentally, discovered by neck sonography. A noticeable sonographic feature in all cases was an isoechoic mass with internal parallel heterogeneous hyperechogenicity. All patients complained of severe pain during FNAB. The cytological results of 2 patients showed fragments of nerve tissue. The remaining 6 FNABs were nondiagnostic. Thyroglobulin (Tg) levels in washout fluids from FNAB of all patients were <0.2 ng/mL, indicating nonthyroidal origin.
Distinctive sonographic features, sharp pain during FNAB, and low Tg levels in FNAB washout fluid can help to diagnose traumatic neuromas without surgery.
评估颈部清扫术后创伤性神经瘤的超声特征。
本研究纳入8例年龄在36 - 69岁(平均49岁)的患者。所有病例中,创伤性神经瘤均在颈部超声检查时偶然发现,用于评估疑似甲状腺高分化乳头状癌的复发情况。对所有超声图像和病历进行回顾性分析。
本研究涵盖8例经临床、实验室检查、细针穿刺活检(FNAB)及其他影像学检查确诊为创伤性神经瘤的病例。所有患者均无神经瘤的临床症状,这些神经瘤是在颈部超声检查时偶然发现的。所有病例中一个显著的超声特征是等回声肿块,内部有平行的不均匀高回声。所有患者在FNAB过程中均主诉剧痛。2例患者的细胞学检查结果显示有神经组织碎片。其余6例FNAB检查结果未明确诊断。所有患者FNAB冲洗液中的甲状腺球蛋白(Tg)水平均<0.2 ng/mL,表明非甲状腺来源。
独特的超声特征、FNAB过程中的剧痛以及FNAB冲洗液中低Tg水平有助于在不进行手术的情况下诊断创伤性神经瘤。