颈部Ⅵ区淋巴结在儿童桥本甲状腺炎超声鉴别诊断中的价值  

Value of Ⅵ Group Neck Lymph Node in Ultrasonic Differential Diagnosis of Hashimoto′s Thyroiditis in Children

作　　者：马文琦[1] 刘百灵[2] 周琦[1] 王莉[3] 姜珏[1] 雷小莹[1] 卫晶丽[2] Ma Wenqi;Liu Bailing;Zhou Qi;Wang Li;Jiang Jue;Lei Xiaoying;Wei Jingli(Department of Ultrasound,the Second Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an,Shaanxi 710004,China;Xi＇an Children＇s Hospital,Xi＇an West 5 Road,Shaanxi 710004,China)

机构地区：[1]西安交通大学第二附属医院超声科,西安市710004 [2]西安市儿童医院 [3]西安交通大学第二附属医院小儿内科,西安市710004

出　　处：《中国超声医学杂志》2018年第9期776-778,共3页Chinese Journal of Ultrasound in Medicine

基　　金：陕西省社会发展科技攻关项目(No.2016SF-210);陕西省重点研发计划项目(No.2017SF-030)

摘　　要：目的探讨颈部Ⅵ区淋巴结在儿童桥本甲状腺炎超声鉴别诊断中的价值。方法选取甲状腺弥漫性疾病患儿85例,其中HT 53例,非HT 32例,选取健康对照组40例。采用常规超声检查所有患儿的甲状腺、颈部Ⅵ区淋巴结显示情况及特征。结果 (1)HT组Ⅵ区淋巴结特征为大小5～10mm,纵横比≥2,淋巴门缺失,低回声,边界清晰,血流缺失,无囊性变,无钙化。(2)颈部Ⅵ区淋巴结显示HT组86.8%(46/53),显著多于非HT组12.5%(4/32)和健康对照组10.0%(4/40),差异有统计学意义(P<0.001),Ⅵ区淋巴结诊断HT的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为86.8%、87.5%、92.0%、80.0%和87.1%。结论颈部Ⅵ区淋巴结是儿童桥本甲状腺炎的特殊征象。Objective To study the value of theⅥ group neck lymph node in ultrasonic differential diagnosis of Hashimoto′s thyroiditis in children.Methods 85 children with diffuse thyroid disease were categorized into Hashimoto′s thyroiditis group（53 cases）and other diffuse thyroid diseases group（32 cases）in accordance with clinical diagnosis,healthy controls（40 cases）.Two-dimensional and color Doppler ultrasound were performed to examine thyroid,examined whether the Ⅵ group neck lymph node was observed,and evaluated the morphology of lymph node.ResultsThe features of Hashimoto′s thyroiditis Ⅵ group neck lymph node were size 5-10 mm,aspect ratio≥2,lack of hilar,hypoechoic,sharp borders,low echogenicty with no cystic necrosis or calcifications.Ⅵ group neck lymph node could be observed in 46 out of 53 Hashimoto′s thyroiditis children,while it could be observed in only 4 out of 32 children with other diffuse thyroid diseases,and in only 4 out of healthy children.The difference between the three groups was statistically significant（P〈0.001）.The sensitivity,specificity,the positive predictive value,the negative predictive value and accuracy rates were 86.8%,87.5%,92.0%,80.0% and 87.1%,respectively.Conclusions Ⅵ group neck lymph node is an additional ultrasound sign of Hashimoto′s thyroiditis in children.

关 键 词：儿童桥本甲状腺炎 颈部Ⅵ区淋巴结 超声 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.8[医药卫生—诊断学]