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对比增强超声与常规超声在判断甲状腺乳头状癌颈部淋巴转移中的意义

Value of Contrast-enhanced Ultrasound and Conventional Ultrasound in the Diagnosis of Papillary Thyroid Carcinoma with Cervical Lymph Node Metastases

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【作者】 张艳罗渝昆张明博杨明张颖李俊来唐杰

【Author】 ZHANG Yan;LUO Yukun;ZHANG Mingbo;YANG Ming;ZHANG Ying;LI Junlai;TANG Jie;Department of Ultrasound,Chinese PLA General Hospital;

【机构】 中国人民解放军总医院超声科

【摘要】 目的对比分析颈部淋巴结转移(LNM)组与无LNM组甲状腺乳头状癌(PTC)超声特征的差异。方法对怀疑为甲状腺癌并拟行手术切除的患者进行常规超声检查及超声造影(CEUS)检查,记录患者年龄、性别及病灶超声特征。以手术病理结果为金标准,比较上述特征在LNM组与非LNM组之间的差异。结果共144例患者,其中51例伴颈部LNM,93例不伴LNM。年龄、性别、病灶数目在LNM组与非LNM组之间的差异无统计学意义(P>0.05)。LNM组癌灶最大径大于0.85 cm,边界不清(P=0.000),形态不规则(P=0.007),内部回声不均匀(P=0.007),伴有微钙化(P=0.020),内部不均匀低增强(P=0.002),周边不规则无增强环(P=0.030)及包膜侵犯(P=0.000)。结论常规超声及CEUS特征可为预测PTC是否发生颈部LNM转移提供有效帮助,特别是CEUS对病灶包膜外侵犯的评估较准确,对LNM的预测有重要意义。

【Abstract】 Objective To compare the ultrasound features of papillary thyroid carcinoma with or without cervical lymph node metastasis( LNM). Methods Patients suspected of thyroid cancer underwent the conventional ultrasound and contrast-enhanced ultrasound( CEUS) examinations. Patients’ age,sex,and ultrasound characteristics of lesions were recorded. With the surgical pathology as the golden standard,the ultrasound features were compared between the cervical LNM group and non-LNM group. Results Of 144 patients,51 had cervical LNM and 93 did not. Patients’ ages,sex and number of lesions had no significant difference between two groups( all P > 0. 05). Tumor with LNM had maximum size greater than 0. 85 cm,ill-defined margin( P =0. 000),irregular shape( P = 0. 007),internal heterogeneous echogenicity( P = 0. 007), microcalcification( P = 0. 020),internal heterogeneous low-enhancement( P = 0. 002),peripheral non-enhancement ring( P =0. 030), and extracapsular extension( P = 0. 000). Conclusions Conventional ultrasound and CEUS are helpful for predicting the cervical LNM of PTC. CEUS can obtain more accurate diagnostic results for the extracapsular extension,which contributes to the prediction of cervical LNM.

【关键词】 甲状腺癌超声病灶超声造影
【Key words】 thyroid cancerultrasoundlesioncontrast-enhanced ultrasound
【基金】 国家自然科学基金(81471681);解放军总医院临床科研扶持基金(2015PC-TSYS-2022)~~
  • 【文献出处】 中国医学科学院学报 ,Acta Academiae Medicinae Sinicae , 编辑部邮箱 ,2017年02期
  • 【分类号】R445.1;R736.1
  • 【被引频次】43
  • 【下载频次】263
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