| 卜锐,杨娜,夏春娟,马峻峰,陆健斐,丁昱,易晓佳,赵丽娜.高频超声术前诊断甲状腺乳头状癌患者颈部转移性淋巴结[J].中国医学影像技术,2019,35(1):55~58 |
| 高频超声术前诊断甲状腺乳头状癌患者颈部转移性淋巴结 |
| Preoperative high-frequency ultrasound in diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma |
| 投稿时间：2018-03-02 修订日期：2018-08-27 |
| DOI：10.13929/j.1003-3289.201803009 |
| 中文关键词: 甲状腺肿瘤 癌,乳头状 淋巴结 肿瘤转移 超声检查 |
| 英文关键词:thyroid neoplasms carcinoma, papillary lymph nodes neoplasm metastasis ultrasonography |
| 基金项目:2014年云南省科技厅-昆明医科大学联合专项基金（2014FB036）。 |
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| 中文摘要: |
| 目的 探讨甲状腺乳头状癌患者颈部淋巴结转移的术前高频超声声像图特征。方法 回顾性分析212例甲状腺乳头状癌患者资料，根据术后组织病理学结果分为无颈部淋巴结转移组（n=103）、颈部淋巴结转移组（n=109）。分析2组淋巴结的声像图表现及转移性淋巴结的颈部分布区域。结果 颈部淋巴结转移组颈部淋巴结皮髓质分界不清且淋巴门消失、回声增强，淋巴结长短径比<2，淋巴结短径>5 mm，淋巴结内多个点状强回声，淋巴结血流呈混合型或周围型，淋巴结血流丰富者分别占86.24%（94/109）、70.64%（77/109）、41.28%（45/109）、17.43%（19/109）、53.21%（58/109）、48.62%（53/109）；无颈部淋巴结转移组上述征象分别占16.50%（17/103）、2.91%（3/103）、11.65%（12/103）、1.94%（2/103）、17.48%（18/103）、16.50%（17/103），2组间各超声征象差异均有统计学意义（P均<0.001）。以手术所见分区为标准，颈部淋巴结转移组术前超声对淋巴结分区的诊断准确率分别为颈Ⅵ区57.58%（38/66）、颈Ⅴ区75.00%（3/4）、颈Ⅳ区81.25%（13/16）、颈Ⅲ区76.92%（10/13）、颈Ⅱ区70.00%（7/10）。结论 术前甲状腺乳头状癌颈部淋巴结转移的高频超声表现具有特征性，对外科确定颈部淋巴结处理策略有指导作用。 |
| 英文摘要: |
| Objective To explore preoperative high-frequency ultrasound in diagnosis of cervical lymph node metastases in patients with papillary thyroid carcinoma (PTC). Methods Data of 212 patients with PTC were analyzed retrospectively.The patients were divided into cervical lymph node non-metastasis group (n=103) and cervical lymph node metastasis group (n=109). The ultrasonic characteristics of the two groups were compared, and lymph node distribution was analyzed in cervical lymph node metastases group. Results The ultrasonic characteristics of cervical lymph node metastasis group included ill-defined boundary between the cortex and medulla of the cervical lymph nodes, combined with the absence of lymphatic hilum and echo enhancement (94/109, 86.24%), the long axis and short axis ratio less than 2 (77/109, 70.64%), the short axial diameters more than 5 mm (45/109, 41.28%), the internal multiple punctuate echogenic foci (19/109, 17.43%), the peripheral vascularity or mixed vascularity (58/109, 53.21%), the abundant blood supply (53/109, 48.62%), while those in cervical lymph node non-metastasis group were 16.50% (17/103), 2.91% (3/103), 11.65% (12/103), 1.94% (2/103), 17.48% (18/103) and 16.50% (17/103), respectively. All these ultrasonic characteristics were significantly different between the two groups (all P<0.001). Taken surgical division as standards, the diagnostic accuracy of preoperative ultrasound for lymph node dissection in cervical lymph node metastasis group was 57.58% (38/66) in level Ⅵ, 75.00% (3/4) in level Ⅴ, 81.25% (13/16) in level Ⅳ, and 76.92% (10/13) in level Ⅲ, 70.00% (7/10) in level Ⅱ. Conclusion Preoperative PTC with cervical lymph node metastasis has characteristic high-frequency ultrasound features, which may guide surgical treatment strategy in cervical lymph node dissection. |
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