| 林文金,薛恩生,林振湖,梁荣喜,钱清富,唐秀斌,陈聪.构建甲状腺癌颈部淋巴结转移影像报告和数据系统[J].中国医学影像技术,2021,37(10):1452~1455 |
| 构建甲状腺癌颈部淋巴结转移影像报告和数据系统 |
| Establishing thyroid carcinoma cervical lymph-node metastasis imaging reporting and data system |
| 投稿时间：2021-02-04 修订日期：2021-08-06 |
| DOI：10.13929/j.issn.1003-3289.2021.10.003 |
| 中文关键词: 甲状腺肿瘤 淋巴结转移 超声检查 |
| 英文关键词:thyroid neoplasms lymphatic metastasis ultrasonography |
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| 中文摘要: |
| 目的 构建甲状腺癌颈部淋巴结转移影像报告和数据系统（TCCLMI-RADS）。方法 收集302例接受颈部淋巴结超声检查并经穿刺活检组织病理学检查确诊的甲状腺癌患者（328个颈部淋巴结），根据病理结果将其分为转移组（192例、211个颈部淋巴结）和非转移组（110例、117个颈部淋巴结），比较2组淋巴结超声表现。以组间差异有统计学意义的超声指标为自变量，以病理结果为因变量，行Logistic回归分析，筛选与淋巴结转移相关的独立预测指标，并将之赋分；构建TCCLMI-RADS，观察其预测甲状腺癌颈部淋巴结转移的效能。结果 相比非转移组，转移组淋巴结短径增大，长短径比（L/S）<2，边缘不规则，边界不清，淋巴结融合，淋巴结门消失，可见高回声、微钙化、囊性变及边缘型/混合型血流信号（P均<0.05）；淋巴结囊性变仅见于转移组。据此构建的TCCLMI-RADS预测甲状腺癌颈部淋巴结转移风险的AUC为0.94（95%CI 0.91~0.97，P<0.001），以2分（2b级）为最佳截断值，其敏感度和特异度分别为89.60%和88.00%。结论 TCCLMI-RADS有助于评估甲状腺癌颈部淋巴结转移风险。 |
| 英文摘要: |
| Objective To establish a thyroid carcinoma cervical lymph-node metastasis imaging reporting and data system (TCCLMI-RADS). Methods Totally 302 patient with thyroid cancer (328 cervical lymph nodes) who underwent cervical lymph node ultrasonography and biopsy were collected and divided into metastasis group (192 cases, 211 lymph nodes) and non-metastasis group (110 cases, 117 lymph nodes) according to pathological results. The ultrasonic manifestations of lymph nodes were observed and compared between groups. Logistic regression analysis was perform taken ultrasonic manifestations being statistically different between groups as independent variables and pathological results as dependent variables, in order to screen independent predictors related to lymph node metastasis and then score for the construction of TCCLMI-RADS. Then the prediction efficiency of TCCLMI-RADS was observed. Results Compared with those in non-metastasis group, short diameter enlargement, long to short axis ratio (L/S)<2, irregular margin, unclear boundary, lymph node fusion, disappearance of lymph node hilus, hyperecho, microcalcification, cystic change and marginal/mixed blood flow signals were observed in more lymph nodes in metastasis group (all P<0.05). Cystic changes of lymph nodes were detected only in metastasis group. Area under the curve (AUC) of TCCLMI-RADS for predicting the risk of cervical lymph node metastasis of thyroid cancer was 0.94 (95%CI 0.91—0.97, P<0.001). Taken 2 points (grade 2b) as the best cut-off value, the sensitivity and specificity of TCCLMI-RADS for predicting the risk of cervical lymph node metastasis of thyroid cancer was 89.60% and 88.00%, respectively. Conclusion TCCLMI-RADS was helpful to evaluating the risk of cervical lymph node metastasis of thyroid cancer. |
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