【摘要】 目的超声诊断甲状腺乳头状癌(PTC)颈部淋巴结清扫术后颈部创伤性神经瘤分析。方法方便选取2018年9月—2019年2月在该院接受治疗的PTC颈部淋巴结清扫术后颈部创伤性神经瘤患者23例,分析患者超声下的病灶位置、数目、形态和大小等情况。结果 23例患者中,多发者4例,单发者19例,总共28例病灶。28例病灶中都出现不均匀的回声,有18例表现为高回声。病灶边界表现模糊的有14例,比较清晰的14例。有21例病灶能观察到和神经相连的征象,在两端的病灶处有线性低回声延长情况,在CDFI的检测中显示低回声线性结构不是血管组织,形状像表示为"吊床式",有2例可以追踪到C4、C5椎体间出现臂丛分支相连情况,有19个病灶没有发现相连的神经。在CDFI检测中有20个病灶可以发现有彩色血流信号,有出现很少的点状血流情况,其他8例病灶没有明显性的血流信号。有23例在超声引导下进行细针穿刺活检,都出现主诉针刺部位剧烈的疼痛感,而针尖移开后又无疼痛感了。28个病灶均有US-FNAB结果显示,有3个病灶在涂片中有鞘细胞、胶原纤维、可见轴索纤维、纤维母细胞混合性的增函数能情况,瘢痕结构表现混乱、结构重叠情况。结论在进行PTC颈部淋巴清扫区域手术后,病灶处出现低回声,在病灶两端出现和神经纤维有链接的明显声像图特征,而且在穿刺时患者出现明显的疼痛感,这时需要注意患者可能有创伤性神经瘤。更多还原

【Abstract】 Objective To evaluate the value of ultrasonography in the diagnosis of traumatic cervical neuroma after neck lymph node dissection for thyroid papillary carcinoma(PTC). Methods Convenient select Twenty-three patients with traumatic cervical neuroma after PTC neck lymph node dissection from September 2018 to February 2019 were analyzed.The location, number, shape and size of lesions under ultrasound were analyzed. Results Of the 23 patients, 4 were multiple and 19 were solitary, with a total of 28 lesions. Nonuniform echoes were found in 28 cases, and hyperechoic echoes were found in 18 cases. There were 14 cases with blurred lesion boundary and 14 cases with clear lesion boundary. There were 21 lesions with nerve connection. Linear hypoechoic prolongation was observed at both ends of the lesion. CDFI showed that the hypoechoic linear structure was not vascular tissue. The shape of the lesion was "hammock". Two cases could be traced to brachial plexus connection between C4 and C5 vertebral bodies. 19 lesions were not found. There are found connected nerves. In CDFI examination, 20 lesions showed color blood flow signals, with little punctate blood flow, and 8 other lesions had no obvious blood flow signals. Twenty-three cases underwent ultrasound-guided fine needle aspiration biopsy, all of them complained of severe pain at the needle site, and no pain was felt after the needle tip was removed. The results of USFNAB in all 28 lesions showed that there were three lesions in the smear, including sheath cells, collagen fibers, visible axonal fibers and fibroblasts. Conclusion After PTC neck lymph node dissection, hypoechoic lesions appear, obvious ultrasonographic features with links to nerve fibers appear at both ends of the lesion, and obvious pain sensation occurs during puncture. It is necessary to pay attention to the possibility of traumatic neuroma in patients.更多还原