经淋巴管超声造影在甲状腺癌转移淋巴结中的应用  

Application of trans-lymphatic contrast-enhanced ultrasound in lymph node metastasis of thyroid cancer

作　　者：欧阳飞 张彤[2] 徐薇[1] OUYANG Fei;ZHANG Tong;XU Wei(Department of Ultrasonography,the First Affiliated Hospital of Yangtze University,Hubei,Jingzhou 434000,China;Ultrasonic Medical Center,the First People’s Hospital of Chenzhou,Hunan,Chenzhou 423000,China)

机构地区：[1]长江大学附属第一医院超声科,湖北荆州434000 [2]湖南省郴州市第一人民医院超声医学中心,湖南郴州423000 [3]长江大学,湖北荆州434000

出　　处：《中国医药科学》2023年第3期38-42,共5页China Medicine And Pharmacy

基　　金：湖南省卫生健康委科研计划项目(202209022698)。

摘　　要：颈部淋巴结转移在甲状腺癌患者中非常常见,其决定肿瘤的分期和手术策略。因此,颈部转移淋巴结的术前准确识别至关重要。常规超声因其诊断性能不高导致临床应用受到限制,经静脉超声造影检查可提供淋巴结的血流灌注信息,为判断淋巴结转移带来了更多的信息,但对于淋巴结中具有相同血供模式的转移灶鉴别存在困难。经淋巴管超声造影作为一种新兴的超声显像技术,模拟正常淋巴液回流途径进行造影检查,具有较高的空间和组织分辨率,可清晰显示造影剂在淋巴管和淋巴结内的分布情况,为颈部转移淋巴结的成功定位与定性提供了新思路,目前已逐步应用于临床。经淋巴管超声造影可以在术前准确定位和识别颈部转移淋巴结,有助于防止不必要的淋巴结清扫,保护局部淋巴系统,减少并发症的发生风险,在甲状腺癌前哨淋巴结微转移的检测中具有一定潜力。Cervical lymph node metastasis is very common in patients with thyroid cancer,which determines the tumor stage and surgical strategy.Therefore,accurate preoperative identification of cervical lymph node metastasis is very important.Conventional ultrasound is limited in clinical application because of its poor diagnostic performance.Intravenous contrast-enhanced ultrasound can provide blood flow perfusion information of lymph nodes,which brings more information for judging lymph node metastasis.However,it is difficult to identify metastatic foci with the same blood supply pattern in lymph nodes.As a new ultrasonic imaging technology,trans-lymphatic contrast-enhanced ultrasound simulates the normal lymphatic reflux pathway for angiography,with high spatial and tissue resolution.It can clearly show the distribution of contrast agent in lymphatic vessels and lymph nodes,and provide a new idea for the successful location and characterization of cervical lymph node metastasis.At present,it has been gradually applied in clinical practice.Trans-lymphatic contrast-enhanced ultrasound can accurately locate and identify cervical lymph node metastasis before operation,which is helpful to prevent unnecessary lymph node dissection,protect local lymphatic system and reduce the risk of complications.Therefore,it has certain potential in detecting sentinel lymph node micro-metastasis of thyroid cancer.

关 键 词：甲状腺癌 淋巴结 淋巴管 超声造影 

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