| 范志娜,吴刚,袁建军.超声联合血清Tg、SPECT/CT诊断分化型甲状腺癌术后颈部淋巴结转移[J].中国医学影像技术,2014,30(3):362~365 |
| 超声联合血清Tg、SPECT/CT诊断分化型甲状腺癌术后颈部淋巴结转移 |
| Ultrasonography combined with serum Tg and SPECT/CT in diagnosis of postoperative lymph node metastasis of differentiated thyroid carcinoma |
| 投稿时间：2013-08-26 修订日期：2014-01-24 |
| DOI： |
| 中文关键词: 超声检查 分化型甲状腺癌 淋巴结转移 |
| 英文关键词:Ultrasonography Differentiated thyroid carcinoma Cervical lymphnode metastases |
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| 中文摘要: |
| 目的 探讨高频超声结合血清甲状腺球蛋白（Tg）、SPECT/CT诊断分化型甲状腺癌（DTC）术后颈淋巴结转移的价值。方法 收集185例经手术病理证实的 DTC患者，于131I治疗前常规行甲状腺床区及颈部淋巴结超声扫查，并检查血清Tg；131I治疗1周后行131I全身扫描，SPECT颈部断层与同机CT图像融合；结合各项检查、淋巴结穿刺活检及临床随访等确定转移淋巴结。结果 共确诊60例DTC颈部转移，其中超声发现转移淋巴结41例（41/60，68.33%），SPECT/CT发现45例（45/60，75.00%），血清Tg阳性25例（25/60，41.67%）。超声与SPECT/CT对颈部淋巴结转移的检出率差异无统计学意义（P>0.05），与血清Tg差异有统计学意义（P<0.01）。超声诊断颈淋巴结转移符合率为78.92%（146/185），SPECT/CT诊断符合率为82.70%（153/185），超声联合血清Tg及SPECT/CT的诊断符合率为88.11%（163/185）。结论 超声对于诊断DTC术后颈淋巴结转移有重要价值，结合血清TG、SPECT/CT有助提高颈淋巴结转移检出率。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of ultrasonography combined with serum thyroglobulin (Tg) and SPECT/CT in diagnosis of postoperative lymph node metastasis of differentiated thyroid carcinoma (DTC). Methods Totally 185 DTC patients were enrolled. Ultrasonography examination was performed and serum Tg was measured before 131I treatment. 131I whole body scan was made after 131I treatment. Combining serum Tg, SPECT/CT, lymph node biopsy and clinical follow-up of patients, cervical lymph node metastases were identified. Results Cervical lymph node metastases were detected by ultrasonography in 41 cases (41/60, 68.33%), and by SPECT/CT in 45 (45/60, 75.00%) cases. Among all 60 patients with cervical lymph node metastases,serum Tg was positive in 25 patients (25/60, 41.67%). There was no difference between ultrasonography and SPECT/CT (P>0.05), while significant difference was found between ultrasonography and Tg (P<0.01) in detecting cervical lymph node metastases. The accordance rate of ultrasonography for diagnosing lymph node metastases was 78.92% (146/185), of SPECT/CT was 82.70% (153/185), while of combination of the above methods was 88.11%(163/185). Conclusion Ultrasonography has great diagnostic value for postoperative lymph node metastasis of differentiated thyroid carcinoma. Combination of ultrasonography, SPECT/CT and serum Tg can improve diagnostic accuracy. |
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