Ousehal A, Abdelouafi A, Essodegui F, Ouzidane L, Moumen M, Kadiri R
Service Central de Radiologie, Hôpital Ibn Rochd, Casablanca, Maroc.
Ann Radiol (Paris). 1996;39(3):146-52.
Thyroid disease is a very common disease, essentially affecting women, and raises diagnostic and therapeutic problems. The objective of this study was to specify the value of ultrasonography in the diagnosis and aetiological orientation of these lesions, based on a retrospective study of 100 patients. The results of ultrasonography were compared to the histological results. The aetiologies detected were dominated by benign lesions, particularly adenomas (56 cases), dystrophic goitres (32 cases) and cancers (7 cases). Ultrasonography allowed the detection of clinically impalpable nodules with no isotope scan signs in 11% of cases. The ultrasonographic appearance of benign nodules was variable. Solitary nodules were detected in 63 cases. They were hyperechoic in 15 cases, isoechoic in 8 cases, cystic in 9 cases, and mixed in 31 cases. A peripheral clear halo was revealed in 25 cases and macrocalcifications were present in 17 cases. Malignant lesions were visualized in 7 cases and were solitary in 5 cases. Solitary lesions had a hypoechoic echostructure in 1 case, an isoechoic echostructure in 2 cases and a mixed echostructure in 2 cases. The margins were poorly demarcated in 3 cases, and circumscribed without peripheral halo in 2 cases. Cervical lymphadenopathy was detected in 2 cases. Graves' disease, diagnosed in 2 patients, showed a diffuse hypoechoic appearance of the entire thyroid gland. Ultrasonography is a sensitive morphological method for the diagnosis of thyroid lesions. A detailed and precise analysis of the ultrasound signs of the lesion can suggest that benign or malignant nature of the lesion, which can be completed by Doppler-ultrasound and especially ultrasound-guided needle biopsies.
甲状腺疾病是一种非常常见的疾病，主要影响女性，并引发诊断和治疗方面的问题。本研究的目的是基于对100例患者的回顾性研究，明确超声检查在这些病变的诊断及病因学导向中的价值。将超声检查结果与组织学结果进行比较。检测到的病因以良性病变为主，尤其是腺瘤（56例）、营养不良性甲状腺肿（32例）和癌症（7例）。超声检查在11%的病例中能够检测出临床触诊不到且无同位素扫描征象的结节。良性结节的超声表现各异。共检测到63例孤立性结节。其中15例为高回声，8例为等回声，9例为囊性，31例为混合性。25例可见周边清晰晕环，17例有粗大钙化。7例观察到恶性病变，其中5例为孤立性。孤立性病变中，1例为低回声结构，2例为等回声结构，2例为混合回声结构。3例边界不清，2例边界清晰但无周边晕环。2例检测到颈部淋巴结病。2例患者被诊断为格雷夫斯病，整个甲状腺呈现弥漫性低回声表现。超声检查是诊断甲状腺病变的一种敏感的形态学方法。对病变超声征象进行详细精确的分析可提示病变的良恶性，这可通过多普勒超声尤其是超声引导下针吸活检来完善。
