超声造影微血管成像联合CT对甲状腺乳头状癌颈部淋巴结转移的预测价值  

The Predictive Value of Contrast-enhanced Ultrasound Microvascular Imaging Combined with CT in Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma

作　　者：王春莉 许黎阳 刘向辉 牛丽娟[2] 常青[2] WANG Chun-li;XU Li-yang;LIU Xiang-hui(Department of Ultrasound diagnosis.The First Hospital of Zhang jia kou City,Zhang jia kou 075041,Hebei Province,China)

机构地区：[1]河北省张家口市第一医院超声诊断科,河北张家口075041 [2]中国医学科学院肿瘤医院超声诊断科,北京100021

出　　处：《中国CT和MRI杂志》2020年第11期36-38,72,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨超声造影微血管成像联合CT对甲状腺乳头状癌颈部淋巴结转移的预测价值。方法选取2017年5月至2019年5月我院收治的甲状腺乳头状癌患者90例,根据其病理结果将其分为转移组45例和未转移组45例,对其进行CT检查以及超声造影检查,分析患者颈部淋巴结转移情况,探究两种诊断方式以及联合诊断的应用价值。结果病理检查共检出阳性淋巴结145枚,其中CT检出率为73.1%,超声造影检查检出率为79.3%,联合检查检出率为95.9%,超声造影检查阳性率高于CT检查(P<0.05),联合检查阳性率高于超声造影检查以及CT检查阳性率(P<0.05);转移组与未转移组患者多呈现低增强灌注,且边缘区灌注强度多高于中央区,增强强度不均匀高于均匀,但是转移组与未转移组无明显差异(P>0.05);转移组边缘区PI、AUC高于未转移组边缘区(P<0.05),其余参数转移区与未转移组无明显差异(P>0.05)。结论采用超声造影微血管成像联合CT对甲状腺乳头状癌颈部淋巴结转移进行检测,其阳性检测率明显高于单纯使用一种诊断方式,且甲状腺乳头状癌边缘区转移患者PI、AUC明显高于未转移患者,可将PI、AUC作为区分患者有无发生颈部淋巴结转移的参考指标。Objective To investigate the predictive value of contrast-enhanced ultrasound microvascular imaging combined with CT in cervical lymph node metastasis of papillary thyroid carcinoma.Methods A total of 90 patients with papillary thyroid carcinoma admitted to our hospital from May 2017 to May 2019 were selected and divided into metastasis group(45 cases)and non metastasis group(45 cases)according to the pathological results.The above patients were examined by CT and contrast-enhanced ultrasound(CEUS).The cervical lymph node metastasis of patients was analyzed,and the application value of the two methods in diagnosis and combined diagnosis was explored.Results The positive rate of CEUS was higher than that of CT(73.1%),CEUS(79.3%)and joint examination(95.9%).The positive rate of CEUS was higher than that of CEUS and CT(P<0.05).The positive rate of combined examination was higher than that of CEUS and CT(P<0.05)However,there was no significant difference between the metastatic group and the non metastatic group(P>0.05);the PI and AUC of the marginal zone in the metastatic group were higher than those in the marginal zone of the non metastatic group(P<0.05),and there was no significant difference in the other parameters between the metastatic area and the non metastasis group(P>0.05).Conclusion The positive detection rate of cervical lymph node metastasis of papillary thyroid carcinoma was significantly higher than that of single diagnosis method,and the edge area of thyroid papillary carcinoma metastasis in patients with PI,AUC is significantly higher than the patients without metastasis,PI and AUC can be taken as reference to distinguish patients with and without cervical lymph node metastases.

关 键 词：超声造影微血管成像 CT检查 甲状腺乳头状癌 颈部淋巴结转移 

分 类 号：R736[医药卫生—肿瘤] R814[医药卫生—临床医学]