淋巴管超声造影与静脉超声造影在鉴别诊断甲状腺癌颈部转移淋巴结中的应用  

Lymphatic and Venous Contrast-Enhanced Ultrasound Imaging for Differential Diagnosis of Cervical Lymph Node Metastasis in Thyroid Cancer

作　　者：李旭 万文博 高天 苟涛华 张艳 LI Xu;WAN Wenbo;GAO Tian;GOU Taohua;ZHANG Yan(Department of Ultrasound,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心超声诊断科,北京100853

出　　处：《中国医学科学院学报》2025年第1期16-22,共7页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81901746)。

摘　　要：目的探讨新型经淋巴管超声造影(LCEUS)与传统静脉超声造影(VCEUS)在甲状腺癌患者颈部淋巴结良恶性鉴别诊断中的价值。方法对怀疑甲状腺癌并拟行超声引导下穿刺活检的患者行颈部淋巴结常规超声、VCEUS及LCEUS检查。以病理结果为金标准,比较常规超声、VCEUS及LCEUS对颈部转移淋巴结的诊断能力。结果纳入44例患者,共52枚淋巴结,病理证实转移淋巴结38枚,未转移14枚。LCEUS诊断转移淋巴结的灵敏度、特异度、准确度分别为97.37%、71.43%、90.38%,VCEUS的灵敏度、特异度、准确度分别为92.11%、35.71%、76.92%,常规超声的灵敏度、特异度、准确度分别为94.74%、21.43%、75.00%。受试者工作特征曲线分析结果显示LCEUS诊断甲状腺癌颈部转移淋巴结的曲线下面积明显高于VCEUS(P=0.020)及常规超声(P<0.001)。结论LCEUS可明显提高甲状腺癌患者颈部淋巴结的鉴别诊断能力,为临床精准治疗提供充足依据。Objective To investigate the value of the novel lymphatic contrast-enhanced ultrasound(LCEUS)and conventional venous contrast-enhanced ultrasound(VCEUS)in the differential diagnosis of benign and malignant cervical lymph nodes in patients with thyroid cancer.Methods Patients with suspected thyroid cancer underwent conventional ultrasound,VCEUS,and LCEUS examinations of cervical lymph nodes before biopsy.The diagnostic abilities of conventional ultrasound,VCEUS,and LCEUS were compared with pathological results as the golden standard.Results Forty-four patients with 52 lymph nodes were included in the final data.Thirty-eight metastatic lymph nodes were confirmed by pathological results,and 14 were benign.The diagnostic sensitivity,specificity,and accuracy were 97.37%,71.43%,and 90.38%for LCEUS,92.11%,35.71%,and 76.92%for VCEUS,and 94.74%,21.43%,and 75.00%for conventional ultrasound,respectively.The area under the curve of LCEUS analyzed by the receiver operating characteristic curve was greater than that of VCEUS(P=0.020)and conventional ultrasound(P<0.001).Conclusion LCEUS could significantly improve the differential diagnosis of cervical lymph node metastasis in the patients with thyroid cancer,providing a basis for precise clinical treatment.

关 键 词：甲状腺 超声 超声造影 淋巴结 

分 类 号：R44.451[医药卫生—诊断学]