超声造影预测甲状腺乳头状癌颈部淋巴结转移的临床价值  

Clinical value of contrast-enhanced ultrasonography in predicting cervical lymph node metastasis of papillary thyroid carcinoma

作　　者：施燕芸[1] 李念芬[1] 孙红光[1] 张文[1] 程红[1] 鞠萍[1] 丁永玲[1] 诸林海[1] 戚庭月[1] $HI Yanyun;LI Nianfen;SUN Hongguang;ZHANG Wen;CHENG Hong;.IU Ping;DING Yongling;ZHU Linhai;QI Tingyue(Department of Ultrasound,the Affiliated Hospital of Yangzhou University,.liangsu 225012,China)

机构地区：[1]扬州大学附属医院超声科,江苏省扬州市225012

出　　处：《临床超声医学杂志》2018年第8期526-530,共5页Journal of Clinical Ultrasound in Medicine

基　　金：扬州市科技计划社会发展面上项目(YZ2017085)

摘　　要：目的探讨超声造影在预测甲状腺乳头状癌(PTC)颈部淋巴结转移中的应用价值。方法回顾性分析64例PTC患者(共71个结节)的超声造影资料,根据术后病理结果,分为转移组(37个结节)和未转移组(34个结节),应用QLAB软件进行超声造影定量分析,绘制PTC结节边缘区及中央区的时间-强度曲线(TIC),并获得上升时间(RT)、峰值强度(PI)、平均渡越时间(MTT)、曲线下面积(AUC)、峰值降半时间(TPH)、上升斜率(WIS)及达峰时间(TTP),分析比较两组PTC结节边缘区及中央区的超声造影灌注强度特征及定量参数差异;绘制相关参数判断PTC淋巴结转移的受试者工作特征(ROC)曲线,计算其诊断效能。结果 PTC结节多表现为不均匀低增强,达峰时结节边缘区灌注强度大于中央区;两组结节灌注强度特征比较差异均无统计学意义。转移组PTC结节边缘区PI、AUC分别为(8.39±2.19)d B、(220.69±83.56)d B s,未转移组PTC结节边缘区PI、AUC分别为(6.52±2.32)d B、(168.29±52.95)d B s,两组比较差异均有统计学意义(均P<0.01);余各参数比较差异均无统计学意义。PTC结节边缘区PI、AUC判断颈部淋巴结转移的ROC曲线下面积分别为0.733、0.708,当PTC结节边缘区PI临界值>8.04 d B、AUC临界值>202.99 d B s时,其判断颈部淋巴结转移的敏感性、特异性分别为67.6%、82.4%和64.9%、79.4%。结论 PTC结节边缘区超声造影定量参数PI、AUC对预测PTC颈部淋巴结转移具有一定的临床应用价值。Objective To evaluate the application value of contrast-enhanced ultrasonography（CEUS）in predicting cervical lymph node metastasis of papillary thyroid carcinoma.Methods The CEUS data of 71 PTC nodules in 64 patients was analyzed retrospectively.The PTC nodules were divided into cervical lymph node metastasis group（n=37）and non-cervical lymph node metastasis group（n=34）according to pathological findings.Time-intensity curve（TIC）of the peripheral and central area of each nodules was drawn by QLAB software.CEUS quantitative parameters were obtained as follows：the rise time（RT）,the peak intensity（PI）,the mean transit time（MTT）,the area under the curve（AUC）,the time from peak to half（TPH）,the wash in slope（WIS）and the time to peak（TTP）.The CEUS perfusion intensity characteristics and quantitative parameters of the peripheral and central area of PTC nodules in the two groups were compared and analyzed.The receiver operating characteristics（ROC）curves of the quantitative parameters with PTC lymph node metastasis were plotted.Results Most of the PTC nodules were characterized by inhomogeneous low-enhancement,and the perfusion intensity in the peripheral area of the nodule was greater than that in the central area at peak time.There was no significant difference between the metastasis group and non-metastasis group in the perfusion intensity features of the PTC nodules. PI and AUC in the peripheral area of the metastasis group were（8.39±2.19）d B and（220.69±83.56）d B s,respectively.Accordingly,which were（6.52±2.32）d B and（168.29±52.95）d B s,respectively in the nonmetastasis group.The difference between the two groups was statistically significant（all P〈0.01）,while there was no significant difference of other parameters between the two groups.The AUC value of PI and AUC in the peripheral area in predicting lymph node metastasis was 0.733 and 0.708,respectively.PI showed a 67.6% sensitivity and 82.4%% specificity with the cutoff value of8.04 d B,and

关 键 词：超声检查 造影剂 定量参数 甲状腺乳头状癌 淋巴结转移 边缘区 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]