彩超结合CT分区评估甲状腺乳头状癌淋巴结转移的探讨＊  

The combination of ultrasound and CT evaluate lymph node metastasis of thyroid papillary carcinoma in different compartments

作　　者：吴干勋[1,2] 陈伟 杨丽[1,4] 胡俊兰[1,2] 赵瑞力[1,2] 葛俊恒[1,2] 赵岩[1,2] 王占龙[1,2] 

机构地区：[1]河北医科大学第四医院 [2]河北省肿瘤医院耳鼻咽喉头颈外科,石家庄050011 [3]河北省肿瘤医院超声科 [4]河北省肿瘤医院影像科

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第4期252-255,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：河北省科技支撑计划(No:13277746D)

摘　　要：目的:探讨术前彩超结合增强CT分区评估甲状腺乳头状癌淋巴结转移的价值。方法:收集术前行颈部彩超同时行颈部、纵隔薄层增强CT检查的115例(141侧)甲状腺乳头状癌的临床资料,分为彩超组、CT组及彩超结合CT组分析比较三组在评估不同区域甲状腺乳头状癌淋巴结转移中的作用。结果:评估颈中央区淋巴结转移,彩超、CT及彩超结合CT三组的准确率分别是61.0%,48.9%,62.4%;评估颈侧区淋巴结转移,彩超、CT及彩超结合CT三组的准确率分别是87.9%,78.7%,85.8%。彩超在颈中央区(P<0.05)及颈侧区(P<0.05)评估淋巴结转移的准确率均高于CT。彩超结合CT检查在颈中央区的准确率高于CT(P<0.05),而在颈侧区的准确率与CT比较差异无统计学意义(P>0.05)。无论在颈中央区(P>0.05)或在颈侧区(P>0.05),彩超与两者联合检查的准确率比较无统计学差异。术前CT考虑6例纵隔转移及1例咽旁间隙转移,术后病理证实均为淋巴结转移。纵隔增强CT扫描发现5例患者肺部转移。结论:彩超结合CT或单一彩超评估颈中央区及颈侧区甲状腺乳头状癌淋巴结转移的准确性要高于CT。CT可以评估纵隔等彩超探及不到的区域淋巴结转移,同时对肺部转移进行评估。彩超结合增强CT应用于甲状腺乳头状癌淋巴结的评估,较单一检查更加精确、全面。Objective： To evaluate the role of the combination of ultrasound and enhanced CT in analyzing lymph node metastasis in thyroid papillary carcinoma（PTC） patients by compartment. Method：Clinical data of 115 cases（141 sides） with PTC were collected. All had undergone ultrasound in neck and enhanced CT both in neck and in imediastinum before surgery. They were divided into ultrasound group, CT group, and the combination of ultrasound and enhanced CT group to evaluate lymph node metastasis. Result：For the central compartment, the ac-curacy of ultrasound was 61.0%, CT was 48. 9%, and the combination of ultrasound and CT was 62.4%. For the lateral compartment, ultrasound was 87. 9%, CT was 78. 7%, the combination of ultrasound and CT was 85.8%. Ultrasound had higher accuracy than CT in the central（P〈0.05）and lateral（P〈0.05）compartment. The combination of ultrasound and CT had higher accuracy than CT in the central compartment（P〈0.05）, but there was no significant difference in the lateral compartment（P）〉0.05）. There was no significant difference in accuracy between ultrasound and the combination of ultrasound and CT neither in eentral（P^0.05） nor in lateral（P.＇〉 0.05）compartment. Six cases of lymph node metastasis in mediastinum and 1 case in parapharyngeal space detected by CT were pathologically proven. CT found that five patients with pulmonary metastasis. Conclusion：The combi- nation of ultrasound and CT or single ultrasound has higher accuracy in preoperative evaluation than single CT forlymph node metastasis in PTC. CT can assess some compartments such as mediastinum which can＇t be detected by ultrasound, and at the same time to evaluate lung metastasis. To evaluate lymph node metastasis in PTC, the combination of ultrasound and CT is more accurate and considerate than single method.

关 键 词：甲状腺肿瘤 淋巴结转移 彩超 CT 

分 类 号：R736.1[医药卫生—肿瘤]