Tublin Mitchell E, Alexander Jacob M, Ogilvie Jennifer B
Department of Radiology, University of Pittsburgh School of Medicine, 200 Lothrop St, Pittsburgh, Pennsylvania15213, USA.
J Ultrasound Med. 2010 Jan;29(1):117-20. doi: 10.7863/jum.2010.29.1.117.
Absorbable gelatin compressed sponge (Gelfoam; Pfizer Inc, New York, NY), a biodegradable agent prepared from purified porcine skin gelatin, is frequently used for intraoperative hemostasis. Its appearance on sonography may mimic tumor or residual thyroid when placed in the resection bed after thyroidectomy. The purpose of this study was to describe the appearance of Gelfoam on early post-thyroidectomy sonography so that an erroneous diagnosis of locally recurrent or residual tumor can be avoided.
We reviewed the early postoperative sonographic examinations of 6 patients after thyroidectomy in which Gelfoam was used for hemostasis. Screening cervical sonography was performed to identify possible lateral compartment adenopathy before completion of thyroidectomy or ablation. Sonographic examinations were performed up to 50 days after resection. Surgical reports confirmed the use of Gelfoam in each patient.
In all cases, uniform elongated echogenicity was shown within the lobectomy bed. In 1 patient, sonographically guided fine-needle aspiration of lobectomy bed echogenicity yielded scant red blood cells, multinucleated giant cells, and macrophages. Follow-up sonography performed in 1 patient 14 months after thyroidectomy confirmed complete Gelfoam absorption.
Gelfoam may mimic residual or recurrent thyroid carcinoma on early surveillance sonography performed after thyroidectomy. Recognition of its characteristic appearance should prompt a search for an appropriate surgical history and, when placed in the appropriate clinical context, should prevent an errant diagnosis of tumor.
可吸收明胶海绵（Gelfoam；辉瑞公司，纽约，纽约）是一种由纯化猪皮明胶制备的可生物降解制剂，常用于术中止血。甲状腺切除术后将其置于切除床时，其在超声检查中的表现可能会模仿肿瘤或残留甲状腺组织。本研究的目的是描述甲状腺切除术后早期超声检查中Gelfoam的表现，以避免对局部复发或残留肿瘤做出错误诊断。
我们回顾了6例甲状腺切除术后使用Gelfoam止血患者的术后早期超声检查。在甲状腺切除或消融完成前，进行颈部超声筛查以确定可能的侧方淋巴结病变。切除术后50天内进行超声检查。手术报告证实每位患者均使用了Gelfoam。
在所有病例中，叶切除床内均显示均匀的细长回声。在1例患者中，对叶切除床回声进行超声引导下细针穿刺，获得少量红细胞、多核巨细胞和巨噬细胞。1例患者在甲状腺切除术后14个月进行的随访超声检查证实Gelfoam已完全吸收。
甲状腺切除术后早期监测超声检查中，Gelfoam可能会模仿残留或复发性甲状腺癌。认识其特征性表现应促使寻找合适的手术史，并且在置于适当的临床背景下时，应防止对肿瘤做出错误诊断。
