常规超声结合弹性分级与应变比在甲状腺癌转移性淋巴结中的应用  

Application of Ultrasound Combined with Elastic Grading and Strain Rate Ratio in Metastatic Lymph Nodes of Thyroid Cancer

作　　者：宋建明[1] 邹良英[1] 曾琪[1] 游宇光[1] 陈卫华[1] 叶军[1] 曾晓英[1] Song Jianming;Zou Liangying;Zeng Qi;You Yuguang;Chen Weihua;Ye Jun;Zeng Xiaoying(Department of Ultrasound,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000,China)

机构地区：[1]赣南医学院第一附属医院超声医学科,江西省赣州市341000

出　　处：《中国超声医学杂志》2024年第1期8-12,共5页Chinese Journal of Ultrasound in Medicine

基　　金：江西省赣州市指导性科技计划项目(No.GZ 2021ZSF065)。

摘　　要：目的 探讨常规超声(US)结合超声弹性成像(UE)分级与弹性应变比(SR)在甲状腺癌转移性淋巴结中的应用价值。方法 回顾性分析126例甲状腺癌患者共160个颈部淋巴结US和UE表现,观察淋巴结常规超声和彩色多普勒血流成像(CDFI)特征,并进行UE分级,测量弹性SR,诊断本组淋巴结转移性的最佳临界值,分别计算US、UE分级、SR,以及联合诊断法对本组淋巴结转移性的灵敏度、特异度、准确度、阴性预测值、阳性预测值,分析4种方法对甲状腺癌转移性淋巴结的诊断价值。结果 本组转移性淋巴结US主要表现为淋巴结门消失、回声不均匀增强、微钙化、囊性变、血流信号增多;其超声弹性分级主要表现为Ⅲ~Ⅳ级;SR对本组淋巴结转移性的最佳诊断临界值为3.25;联合诊断法对鉴别淋巴结转移性的灵敏度、特异度、准确度、阴性预测值、阳性预测值及其受试者工作特征(ROC)曲线下面积明显高于单一诊断法。结论 US联合UE对甲状腺癌淋巴结转移性判断具有较好的诊断价值。Objective To explore the application value of ultrasound(US)combined with ultrasonic elastography(UE)grading and elastic strain rate ratio(SR)in metastatic lymph nodes of thyroid cancer.Methods A retrospective analysis was conducted on the US and UE manifestations of 160 cervical lymph nodes in 126 patients with thyroid cancer.The two-dimensional and color Doppler flow imaging(CDFI)characteristics of lymph nodes were observed,and UE grading was performed.The SR was measured to determine the optimal threshold for diagnosing lymph node metastasis.The sensitivity,specificity,accuracy,negative predictive value,and positive predictive value of US,UE grading,SR,and combined diagnostic methods were calculated for lymph node metastasis,in order to analyze the diagnostic value of four methods for metastatic lymph nodes in thyroid cancer.Results The main manifestations of ultrasound in this group of metastatic lymph nodes were disappearance of lymph nodes,enhanced echo,microcalcification,cystic transformation,and increased blood flow signals.The elastic grading of metastatic lymph nodes mainly manifests as gradesⅢ~Ⅳ.The optimal diagnostic threshold for lymph node metastasis in this group by SR was 3.25.The sensitivity,specificity,accuracy,negative predictive value,positive predictive value and the area under the receiver operating characteristic of the combined diagnostic method were significantly higher than those of the single diagnostic method.Conclusions The combination of US and UE has good diagnostic value in determining lymph node metastasis in thyroid cancer.

关 键 词：甲状腺癌 淋巴结 超声 弹性成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]