超声造影在甲状腺乳头状癌淋巴结转移诊断中的作用分析  

Analysis of the effect of contrast-enhanced ultrasound in diagnosis for lymphatic metastasis of papillary thyroid carcinoma

作　　者：谭小蕖[1] 钱林学[1] 刘玉江[1] 赵军凤[1] TAN Xiao-qu;QIAN Lin-xue;LIU Yu-jiang(Department of Ultrasound, Beijing Friendship Hospital of Capital Medical University,Beijing, 100050, China)

机构地区：[1]首都医科大学附属北京友谊医院超声科,北京100050

出　　处：《中国医学装备》2017年第12期4-7,共4页China Medical Equipment

基　　金：基金项目:首都临床特色应用研究(Z131107002213143)"超声引导继发甲旁亢微波/射频治疗新技术评价"

摘　　要：目的:探讨超声造影对二维超声形态异常的甲状腺乳头状癌(PTC)患者颈部淋巴结良恶性诊断意义。方法:选取67例确诊为甲状腺乳头状癌术前或术后患者,且二维超声发现颈部淋巴结形态改变,包括淋巴结门消失、纵横比(L/S)≤2、囊性变、点状钙化以及皮质局部回声增强,进行超声造影,观察淋巴结的造影模式。正常强化模式为离心性增强,异常增强模式为向心性增强、混合性增强及不均匀增强(局部低灌注、高灌注或缺损),比较二者的诊断价值。结果:在所有病例中,二维超声阳性预测值为54.1%,使用超声造影可使阳性预测值达到81.4%;术后患者二维超声阳性预测值为38.1%,使用超声造影后阳性预测值可提高至70%。结论:超声造影与二维超声联合在PTC颈部淋巴结的评估中具有重要作用。Objective:To investigate the diagnostic value of contrast-enhanced ultrasound for benign and malignant of cervical lymph node of patients with papillary thyroid carcinoma(PTC)whose2-dimensional ultrasound were abnormal.Methods:67pre-postoperative patients with PTC whose2-dimensional ultrasound were abnormal in cervical lymph node were enrolled in this research.And these abnormal appearances included disappeared lymph node,long-to-short axis ratio less than2,cystic degeneration,punctate calcification and echo enhancement at local cortex.And all of them were implemented contrast-enhanced ultrasound so as to observe the imaging model.Centrifugalization was enhanced in normal model,and centrality,miscibility and asymmetry were enhanced in abnormal model.And the diagnostic values of them were compared and analyzed.Results:In all of cases,the positive predictive value of2-D ultrasound was54.1%,while the positive predictive value of contrast-enhanced ultrasound could achieve81.4%.And the positive predictive value of2-D ultrasound for post-operative patients only was38.1%,while contrastenhanced ultrasound could achieve70%for these patients.Conclusion:Contrast-enhanced ultrasound combined with2-D ultrasound has important value in the evaluation for cervical lymph node of PTC.

关 键 词：超声造影 淋巴结转移 甲状腺乳头状癌 二维超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]