甲状腺癌颈部转移性淋巴结的超声诊断分析  

Diagnostic value of ultrasonography in identifying lymph node metastases in patients with thyroid cancer

作　　者：范文涛[1] 宇雪豹[1] 柯和平 宋晓艳 严攀 

机构地区：[1]武汉科技大学附属武汉市汉阳医院超声科,武汉430050

出　　处：《中国肿瘤临床与康复》2017年第9期1067-1070,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨超声检查对甲状腺癌颈部转移性淋巴结的诊断价值。方法选取2013年10月至2016年10月间武汉市汉阳医院收治的64例行甲状腺癌手术的患者,采用术前超声检查及手术病理证实,观察淋巴结的分布区域、数目、形态、边界、纵横比、内部回声、内部有无钙化及内部血流情况等。结果超声探及颈部可疑淋巴结共310枚,其中158枚经病理诊断为甲状腺癌颈部转移性淋巴结,152枚为颈部非转移性淋巴结,超声诊断颈部淋巴结转移符合率为51.0%(158/310)。158枚病理诊断颈部转移性淋巴结中超声显示淋巴结内部髓质消失或偏心发生率为83.5%(132/158),淋巴结内部出现微小钙化发生率为45.6%(72/158),淋巴结纵横比>0.55发生率为60.1%(95/158)。152枚病理诊断颈部非转移性淋巴结中超声显示淋巴结内部髓质消失或偏心发生率为13.2%(20/152),淋巴结内部出现微小钙化发生率为13.2%(20/152),淋巴结纵横比>0.55发生率为23.0%(35/152)。上述三个超声特征分布在转移性和非转移性淋巴结组间比较,差异均有统计学意义(均P<0.01)。转移性淋巴结中形态不规则发生率为26.6%(42/158),非转移性淋巴结中形态不规则发生率为19.1%(29/152),两者比较,差异无统计学意义(P>0.05)。结论超声检查对于甲状腺癌转移性颈部淋巴结具有重要诊断价值。Objective To investigate the value of ultrasonography in the diagnosis of lymph nodes metastases in patients with thyroid cancer.Methods A total of 64 patients with thyroid cancer who underwent surgery at Hanyang Hospital from October 2013 to October 2016 were selected.By preoperative ultrasound and pathological diagnosis,the distribution area,number,shape,boundary,aspect ratio,internal echo and internal calcification and blood flow of lymph nodes were observed.Results Ultrasound diagnosis found 310 potential lymph nodes,among which 158 were detected as metastatic lymph nodes and 152 were non-metastatic by pathology examination.The consistency rate of ultrasound examination was 51.0%（158/310）.For 158 metastatic lymph nodes detected by pathology examination,ultrasound examination found that the incidence of internal medulla loss,off-center,microcalcification and aspect ratio0.55 was83.5%（132/158）,45.6%（72/158） and 60.1%（95/158）,respectively.For 152 non-metastatic lymph nodes detected by pathology examination,ultrasound examination found that the incidence of internal medulla loss,off-center,microcalcification and aspect ratio0.55 was 13.2%（20/152）,13.2%（20/152） and 23.0%（35/152）,respectively.There were statistically significant differences in the above said distributions of 3 features between metastatic and non-metastatic lymph nodes（all P0.01）.Incidence of irregular shape was 26.6%（42/158） for metastatic lymph nodes and 19.1%（29/152） for non-metastatic lymph nodes（P0.05）.Conclusion Ultrasonography shows important significance in diagnosis of lymph nodes metastasis in thyroid cancer.

关 键 词：超声检查 甲状腺肿瘤 颈部转移性淋巴结 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]