血流信号外延评估分化型甲状腺癌后被膜外侵犯  

Blood flow signal extension for evaluation on posterior extracapsular extension of differentiated thyroid carcinoma

作　　者：林娴静 何聚馨 谢丽君[1] 朱丽珊 陈树强[1] LIN Xianjing;HE Juxin;XIE Lijun;ZHU Lishan;CHEN Shuqiang(Department of Ultrasound Medicine,First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院超声医学科,福建福州350005

出　　处：《中国医学影像技术》2023年第2期185-188,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察血流信号外延评估分化型甲状腺癌(DTC)后被膜外侵犯的价值。方法纳入290例经手术病理证实的DTC患者,观察术前结节被膜外受侵位置及其超声表现,包括结节大小、形态及有无血流信号外延、接触被膜、突出被膜外及被膜连续性中断等,并与病理所见进行对比。结果290例DTC患者中,18例(18/290,6.21%)存在前被膜外受侵,26例(26/290,8.97%)后被膜外受侵;后者T分期及淋巴结转移率均高于前者(P均<0.05)。血流信号外延评估DTC后被膜外受侵的敏感度为76.92%,特异度为92.42%,阴性预测值为97.60%,准确率为91.03%。44例存在被膜外受侵的DTC患者中,25例(25/44,56.82%)轻度受侵,19例(19/44,43.18%)重度受侵,轻、重度被膜外受侵DTC超声表现差异均无统计学意义(P均>0.05)。结论血流信号外延可用于评估DTC后被膜外受侵。Objective To explore the value of blood flow signal extension for evaluating posterior extracapsular extension of differentiated thyroid carcinoma(DTC).Methods A total of 290 patients of DTC confirmed by postoperative pathology were ultimately enrolled.The location of extracapsular invasion,the preoperative ultrasonic features of the nodules,including the size,shape and whether the nodule with blood flow signal extension,contacted with capsule,protruded out of the capsular contour and disrupted capsular continuity were observed and compared with pathological findings.Results Among 290 patients of DTC,18(18/290,6.21%)were found with anterior extracapsular extension,while 26(26/290,8.97%)were found with posterior extracapsular extension,and the percentage of T stage and incidence of lymph node metastases were both higher in the latter than in the former(both P<0.05).The sensitivity,specificity,negative predictive value and accuracy of blood flow signal extension for evaluating posterior extracapsular extension was 76.92%,92.42%,97.60%and 91.03%,respectively.Among 44 patients with extracapsular invasion,mild and severe invasion was detected in 25(25/44,56.82%)and 19 patients(19/44,43.18%),respectively.No significant difference of ultrasonic manifestations of DTC was found between those with mild and with severe extracapsular invasion(all P>0.05).Conclusion Blood flow signal extension could be used to evaluate posterior extracapsular extension of DTC.

关 键 词：甲状腺肿瘤 超声检查 被膜 肿瘤血管 

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