超声评估甲状腺癌颈部转移淋巴结的临床研究  

Clinical study of ultrasonography on the evaluation of thyroid cancer with cervical lymphatic metastasis

作　　者：姚怀齐[1] 连楷浼 刘璇芝[1] 林腾[1] YAO Huaiqi;LIAN Kaimei;LIU Xuanzhi;LIN Teng(Department of Ultrasound,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院超声科,广东汕头515041

出　　处：《汕头大学医学院学报》2020年第4期239-241,共3页Journal of Shantou University Medical College

摘　　要：目的:探讨甲状腺癌颈部转移淋巴结进行超声检查的特征及诊断价值。方法:收集2015年1月—2019年12月汕头大学医学院第一附属医院术前诊断为甲状腺乳头状癌并颈部淋巴结异常的55例患者,其中男性12例,女性43例,年龄20~75岁,平均(42.53±3.96)岁。以病理组织学检查结果为标准,观察甲状腺、颈部淋巴结肿大超声检查结果及特征。结果:超声检出颈部淋巴结转移阳性率为45.22%,病理检查结果阳性率为51.30%,两种检查方法差异无统计学意义(P>0.05);超声检出灵敏度为88.14%;转移性淋巴结多呈圆形,长径/短径<2,边界不清,呈融合状,内部呈不均匀低回声,有细小钙化或液化,血流丰富。与反应性增生淋巴结相比,差异均有统计学意义(均P<0.001)。结论:甲状腺乳头状癌颈部淋巴转移具有超声检查特征性表现,是否呈融合状、微钙化、液化,是否存在淋巴结门可作为转移性淋巴结与非转移性淋巴结的鉴别诊断依据。Objective:To investigate the characteristics and diagnostic value of ultrasound examination of cervical metastatic lymph nodes of thyroid cancer.Methods:From January 2015 to December 2019,55 patients with papillary thyroid carcinoma and cervical lymph node abnormalities diagnosed preoperatively in the First Affiliated Hospital of Shantou University Medical College were collected,including 12 males and 43 females,with an average age of(42.53±3.96)years.According to the results of histopathological examination,the results and characteristics of thyroid gland and cervical lymph node enlargement were observed.Results:The positive rate of cervical lymph node metastasis detected by ultrasound was 45.22%,and the positive rate of pathological examination was 51.30%.There was no significant difference between the two inspection methods(P>0.05).The sensitivity of ultrasound detection was 88.14%.Metastatic lymph nodes are mostly round,long diameter/short diameter<2,unclear borders,fused,uneven and hypoechoic inside,with fine calcification or liquefaction,and rich blood flow.Compared with reactive hyperplastic lymph nodes,the differences were statistically significant(all P<0.001).Conclusion:Cervical lymphatic metastasis of papillary thyroid carcinoma has characteristic features of ultrasonography.The presence of fusion,microcalcification,liquefaction,and the presence of lymph node hilum can be used as the basis for the differential diagnosis of metastatic lymph node and non-metastatic lymph node.

关 键 词：超声 甲状腺乳头状癌 淋巴结转移 颈部 

分 类 号：R445.1[医药卫生—影像医学与核医学]