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    CC BC KHO ST TUYN GIP (*)- Ct ngang mi thy t cc trncc di- Ct dc mi thy vi chiu cao ln nht- o th tich TG, bnh thng 7-11cm/thy.

    - Eo gip ct ngang v dc vi k trc-sau ln nht.- C T, c P: hch, M cnh, TM hu.- TG bnh thng: Khng thy bnh l 2 mt ct khc nhau, bao gmc hi m, s o, phn b mch mu.

    TG BNH THNG (**): Kch thc, hnh thi v th tch thay itheo tui v gii.-18-20mm chiu cao v 8-9mm b dy (AP) lc mi sanh.-25 mm chiu cao v 12-15 mm AP lc 1 tui.

    - 40-60 mm chiu cao v 13-18 mm AP lc trng thnh.Th tch bnh thng (khng k eo gip) 10-15ml/n v 12-18ml/nam.

    (*) ULTRASOUND OF THE THYROIDNormal http://www.ultrasoundpaedia.com/normal-thyroid

    (**) Thyroid ultrasound. Vikas Chaudhary, Shahina Bano. Indian Journal of Endocrinology andMetabolism / Mar-Apr 2013 / Vol 17 | Issue 2

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    ULTRASOUND OF THE THYROIDNormal http://www.ultrasoundpaedia.com/normal-thyroid/

    1

    2

    3

    4

    5

    1,2,3: ct ngang thy P,eo gip, thy T.4: ct dc eo gip.5: ct dc mi thy gip

    Tuyn c tr nh

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    1- Tuyn gip; 2- Kh qun; 3- Tuyn cn gip; 4- Tnh mch hu trong;5- ng mch cnh gc; 6- TK hu qut ngc; 7- M gip di

    8- C c gip; 9- C vai mng; 10- C c mng; 11- C c n chm;13- Thc qun; 14- C di c; 15- Ct sng.

    1

    2

    3

    45

    6

    7

    8

    910

    11

    12

    1314

    15

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    KHO ST MCH MU TG- TG c phn b bi M gip trn v di.- Bnh thng RI thp v PSV cao 15-30cm/s cho m trong nhu m gip.a. TG bnh thng, b. M gip di (), c. Ph M vi RI thp, PSVca

    a

    bc

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    - Th tch tuyn gip o c hai thy 8,53cm1,82, trung bnh n7,58cm3 v nam 9,72cm3 ,th tch thy P thng > T (4,48cm3so vi4,07 cm3). V= ngang x dy x cao x 0,49

    The Internet Journal of Radiology,Volume 4, Number 2Ultrasound Determination Of Thyroid Gland Volume Among Adult Nigerians

    A Ahidjo, A Tahir, M Tukur

    TNHTH TCH TUYN GIPCch tnh th tch tuyn gip cha c nht qun, nn c nhiu cch tnty theo trng phi:

    - Th tch tuyn gip = tng th tch hai thy, khng bao gm eo gipVthy= ngang x dy x cao x 0,479

    Method for determining thyroid size by ultrasonographyhttp://www.iccidd.org/cm_data/thyroid_size.pdf

    - Th tch ca mi thy v eo gip tnh theo cng thc hnh bu dc(ngang x dy x cao x /6)Thyroid Volumetric Quantification. J Ultrasound Med 2008; 27:17271733

    http://ispub.com/IJRAhttp://ispub.com/IJRA/4http://ispub.com/IJRA/4/2http://ispub.com/IJRA/4/2/8932http://ispub.com/IJRA/4/2/8932http://ispub.com/IJRA/4/2http://ispub.com/IJRA/4http://ispub.com/IJRA
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    VAI TR C A SI U M- Xc nh khi s thy c/LS nm trong hay ngoi tuyn gip.- phn loi khi s c/LS: nang, c hay hn hp- nh gi cu trc m cn li ca tuyn gip

    -Nhn nh nguyn nhn cng gip, suy gip.- Bin chng sau phu thut: p-xe, ph n- Phnh gip a ht: theo di nhn- Hng dn chc ht t bo, rt dch, sinh thit

    CHN ON PHN BiTNu bnh nhn c khi c v di ng theo nut, cc chn on ngoituyn gip c th c:- Cun m phn y ca c.

    - Hch- Nang khe mang-Nang gip thit (ng gia trn xng mng)- Khi ca tuyn cn gip

    ULTRASOUND OF THE THYROIDNormalhttp://www.ultrasoundpaedia.com/normal-thyroid/

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    CH NH SIU M TG (Theo AACE v AME*)1. Xc nhc nhn gip khi khm lm sng nghi ng.2. Tnh chtca(1 hay nhiu) nhn gip, kch thc, him v phn

    bmchmu.

    3. Phnbitnhn gip lnhc datrn cimSA.4. Phnbitnhn gip vicc khingoi TG: hch, nang gip thit,

    nang mchbchhuyt.5. nhgi thay ilan tatrong nhu m gip.

    6. nhgi m gip cn lisauphuthut, ti pht gingTG, dicnhchc.7. Theo di nhngBN nguy cK gip: tincngia nh, au nitit

    nhm II (multiple endocrine neoplasia (MEN) type II ), xtrvngc.

    8. HngdnFNA.

    (*) American Association of Clinical Endocrinologists (AACE) and Associazione MediciEndocrinologi (AME)

    Thyroid ultrasound. Vikas Chaudhary, Shahina Bano. Indian Journal of Endocrinology andMetabolism / Mar-Apr 2013 / Vol 17 | Issue 2

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    Bnhl lan ta Bnhl khu tr ChcnngTG

    Phnh gip

    Bulnhgip

    K gip

    Vim gip

    Basedow

    Phnh gip lan ta,

    1 hay 2 thy

    -----

    K gip lan ta

    1 hay 2 thy

    2 thy

    -Phnh gip n(a) nhn.

    - 1 hay nhiunang gipkeo/ 1 hay 2 thy.

    1bu/ 1 thyNhn c(ngnhthay

    khng)

    Nhn cecho km (ccnhn lnc hoitbntrong)

    Vim toht: 1 haynhiuht/ 1 hay 2 thy

    --------

    Bnh gip +++

    Cnggip +

    Bnh gip +++Cnggip + (c

    tnh)

    Bnh gip

    Bnh gipCnggip (thongqua)Suy gip

    Cnggip

    BNH HC TUYN GIP

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    NANG

    GIAP

    KEO +++

    NANG DO

    K hiem)

    PGH

    +++)

    BU LANH

    ADENOMA)

    hiem

    K GIAP VIEM

    CNG GIAP

    BASEDOW

    THUOC

    SUY GIAP

    BNH GIAP

    NHN GIP(LS HAY DI LS)

    NHN GIP DNG NANG# NANG GIP

    NHN GIP DNG C

    SAU T LM GiM THTCH TUYN GAP

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    NHN GIP(LS HAY DI LS)

    NHN GIP DNG NANG# NANG GIP

    NHN GIP DNG C

    NANGGIP

    KEO+++

    NANGDO K

    (him)

    PGH

    +++)

    BU LNH(ADENOMA)

    (him)K GIP

    VIEM

    Bnhl khu trPhnh gip

    Bulnhgip

    Phnh gip n(a)nhn. Nang gip keo/1 hay 2 thy.1bu/ 1 thy

    Nhn c(ngnht

    hay khng)

    Bnhl khu trK gip

    Vim gip

    Nhn cecho km(cc nhn lnc hoitbn trong)

    Vim toht

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    M t v tr, s lng, hnhthi, kch thc ca 1 haynhiu nhn

    B h h i

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    15

    Benh hocac iem

    Lanh Ac

    1. Cau truc echo

    ac

    Nang

    Hon hp

    2. oecho

    Kem

    ong

    Day

    3. Gii han

    Gii han ro

    Gii han khong ro4. Halo

    Day / khong toan ven

    Mong / toan ven

    5. Voi hoa **

    Ngoai bien (voso)

    Ben trongTo

    Nho

    (1)

    (2)

    (2)

    (1)

    (3)

    (4)

    (2)

    (2)

    (4)

    (3)

    (1)

    (1)*

    (3)

    (2)

    (2)

    (3)

    (2)

    (1): Kh xc nh, c th gp. (2): c th, thng gp.(3): Kh xc nh, t gp. (4): c th.xc sut xy ra >85%.

    (*): mc d hu ht nhn c u echo km, phn ln cc nhn echo km l lnh tnh.(**): Vi ha: 13% vi ha i km vi nhn, s phn b & kiu vi ha rt quan trng.

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    1/. HT GIP DNG NANG = NANG GIP KEO:Phnlnnang gip thunggpl nang keo do kttdchkeo

    trong cc ti nang, dchstvng (Lugol). C thc 1 haynhiunang

    Lu : K gp khng bao gi biu hin di dng nang han tan

    Nang echo trng ngnht hoc c th vi

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    Nang nh, trong gii hn bnh thng, cth vi dng ui sao chi, rt hay gp

    Nang to, i khi cn thy c mt phn m gip vch nang (), c rt nhiu th vi dng ui saochi, rt hay gp

    Nhn gipdng nang#Nang gip

    keo

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    Nang gip keo xut huyt: dch echo km, c cn, vch ngn trong nang.

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    Nang gip keo xut huyt: cc mu ngc (A) v khng c (B) th vi.

    Nang gip keo xut huyt: th vi trini khp nangCPB vi vi vi ha.

    A B

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    2/. HT GIP DNG C :

    SA nh gi v tr, kch thc, hi m, cu trc echo, b vin, halo, vi ha

    v phn b mch mu

    -Nhn di v bao khi khng c m gip bao chung quanh.- Cc nhnphn bit r vi m gip cn li s c hi m: echo dy, ngecho, echo km hay echo hn hp.

    - ng vin b: u hay khng u.- Cu trc echo: ng nht hay khng ng nht.- Halo l ng vin echo trng hay echo km bao quanh nhn- Vi ha to hay nh nm trong nhn, ra nhn hay c hai- Phn tch cng v loi mch mu phn b cho cc nhn gm: loi I: khngc tn hiu mch mu; loi II: c mch mu quanh nhn, loi III: tng mch mutrong v ngoi nhn.

    Diagnosis of Thyroid Cancer in Children: Value of Gray- Scale and Power DopplerUS. Andrej Lyshchik, MD. Radiology 2005; 235:604613

    BNH HC

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    BNH HCNhn gip : thng gp l PHNH GIP A HT (PGH) nhng c tnh vs lnh tnh: khng c 1 c im SA no gip phn bit bnh l lnh hay cnn cn kt hp nhiu c im :

    -Nang vs c- n c hay a nhn- Echo km vs cc hi m khc- Halo- Vi ha to vs vi vi ha- Phn b mch mu

    TUY N GIP C TNH :- Chim 1% trong cc nhn gip, thng gp l carcinm dng nh hay nh-nang.-T l k gip gia tng khi c iu tr tia x vo vng u c.- K biu m dng nh 78%, K biu m cc tn thng dng nang 17%, K biu m dngty 4%, K biu m dng khng bit ha 1%, lymphm v di cn TG him gp.

    ULTRASOUND OF THE THYROIDNormal http://www.ultrasoundpaedia.com/normal-thyroid

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    Do tnh trng thiu it , l tn thng tng sn lnh tnh.

    PG n ht hay a ht (nodular goiter): Ht c cu trc echo rt a dng

    (tui): echo dy, ng echo, hi km hay rt km so vi ch m gip. Gii

    hn ro hay khng r khu tr 1 hay 2 thy. ng nht hay khng do ckm theo tnh trng vi ha (to trong nhn hay ngoi bin) hay ha nangtrong nhn.

    Chn an phn bit PG tuyn (adenomatous goiter) vi bu lnh TG

    hay k gip da va hnh nh SA nhiu khi khng th c.

    PG A (N) HT.

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    PG ht:ha nangt ong

    vc th

    vi

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    24

    PG ht:khng hanang tong

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