多模态超声定量参数在预测甲状腺乳头状癌颈部淋巴结转移风险中的价值  

The value of multimodal ultrasound quantitative parameters in predicting the risk of cervical lymph node metastasis in papillary thyroid carcinoma

作　　者：马蓉[1] 邵春晖[2] 罗永科 吕品[2] 魏格格 MA Rong;SHAO Chunhui;LUO Yongke;LÜPin;WEI Gege(Department of Pathology,Baoji People's Hospital,Baoji 721000,China;Department of Ultrasound Medicine,Baoji People's Hospital,Baoji 721000,China;Department of Ultrasound,The 987 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Baoji 721000,China)

机构地区：[1]宝鸡市人民医院病理科,陕西宝鸡721000 [2]宝鸡市人民医院超声医学科,陕西宝鸡721000 [3]中国人民解放军联勤保障部队第九八七医院超声科,陕西宝鸡721000

出　　处：《分子影像学杂志》2025年第4期502-508,共7页Journal of Molecular Imaging

基　　金：宝鸡市卫生健康委员会科研计划立项课题(2025-079、2024-052)。

摘　　要：目的探讨多模态超声特征及定量测值参数在预测甲状腺乳头状癌(PTC)发生颈部淋巴结转移风险中的价值。方法回顾性分析2022年10月~2024年10月在宝鸡市人民医院经手术病理证实的117例PTC患者的临床资料,分析剪切波弹性成像(SWE)弹性平均值(E_(mean))与弹性比(ER)、应变弹性成像应变平均值与应变比(SR)、超声造影(CEUS)时间强度曲线(TIC)的上升斜率、峰值强度(PKI)、上升时间、达峰时间、平均强度、时间强度曲线下面积(TIC-AUC)等各定量参数检查结果。以术后病理结果将患者分为未转移组和转移组,比较各定量参数在两组间的诊断价值。采用单因素及多因素二元Logistic回归分析比较两组间颈部淋巴结转移的风险因素。结果颈部淋巴结转移组中男性、结节边缘模糊、结节内细小钙化及结节侵犯被膜占比均高于未转移组,差异有统计学意义(P<0.05)。两组多模态超声各定量参数中,未转移组中应变弹性成像应变比SR与CEUS定量参数PKI及TIC-AUC与转移组相比,差异均有统计学意义(P<0.05);当最佳界值SR≤2.77、PKI≤14.00 dB、TIC-AUC≤1668.09 dB·s时发生颈部淋巴结转移的风险越大。多因素二元Logistic回归分析显示,男性、结节内细小钙化、结节侵犯被膜及CEUS参数PKI、TIC-AUC为PTC发生颈部淋巴结转移风险的独立危险因素(P<0.05)。结论男性、结节内细小钙化、结节侵犯被膜及CEUS参数PKI≤14.00 dB与TIC-AUC≤1668.09 dB·s在预测PTC发生颈部淋巴结转移风险中具有一定价值,能为临床决策提供一定的参考依据。Objective To investigate the value of multimodal ultrasound characteristics and quantitative measurement parameters in predicting the risk of cervical lymph node metastasis of thyroid papillary carcinoma(PTC).Methods Clinical data of 117 patients with PTC confirmed by surgery and pathology from October 2022 to October 2024 at Baoji People's Hospital were retrospectively analyzed.The quantitative parameters of E_(mean) and ER of SWE,SE_(mean) and SR of SE,and the ascending slope,peak intensity(PKI),rising time(RT),peak time(TTP),mTIC and area under time intensity curve(TIC-AUC)of CEUS were analyzed.The postoperative pathological results were divided into two groups(non-metastatic group and metastatic group)to compare the diagnostic value of each quantitative parameter between the two groups.Univariate and multivariate binary Logistic regression analysis was used to compare the risk factors of cervical lymph node metastasis between the two groups.Results In the cervical lymph node metastasis group,the proportion of male,fuzzy nodule edge,small intracodular calcification and nodular invasion capsule was higher than that in the non-metastatic group,with statistical significance(P<0.05).Among the quantitative parameters of multimodal ultrasound in the two groups,the strain elastic imaging strain ratio SR in the non-metastasis group was significantly different from the quantitative parameters of CEUS PKI and TIC-AUC in the metastasis group(P<0.05).When the optimal threshold value SR≤2.77,PKI≤14.00dB,TIC-AUC≤1668.09 dB·s,the risk of cervical lymph node metastasis was greater.Multivariate binary Logistic regression analysis of the two groups of patients showed that males,intra nodular fine calcification,nodular invasion capsule and CEUS parameters PKI,TIC-AUC were independent risk factors for cervical lymph node metastasis of PTC(P<0.05).Conclusion Male,intratodular fine calcification,nodular invasion capsule and CEUS parameters PKI≤14.00 dB and TIC-AUC≤1668.09 dB·s have certain value in predicting the risk o

关 键 词：甲状腺乳头状癌 颈部淋巴结转移 剪切波弹性成像 应变弹性成像 超声造影 细针穿刺细胞学检查 诊断价值 

分 类 号：R736.1[医药卫生—肿瘤]