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颈部清扫术后创伤性神经瘤的超声特征。

Sonographic features of traumatic neuromas after neck dissection.

作者信息

Kwak Jin Young, Kim Eun-Kyung, Kim Min Jung, Son Eunju

机构信息

Department of Diagnostic Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, Korea.

出版信息

J Clin Ultrasound. 2009 May;37(4):189-93. doi: 10.1002/jcu.20566.

Abstract

PURPOSE

To evaluate the sonographic features of traumatic neuromas after neck dissection.

METHODS

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.

RESULTS

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.

CONCLUSION

Distinctive sonographic features, sharp pain during FNAB, and low Tg levels in FNAB washout fluid can help to diagnose traumatic neuromas without surgery.

摘要

目的

评估颈部清扫术后创伤性神经瘤的超声特征。

方法

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。

结果

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。

结论

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。

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