彩色多普勒超声与增强CT对甲状腺乳头状癌术后复发或转移的诊断价值比较

Comparison between color Doppler ultrasound and contrast-enhanced CT in diagnosis of postoperative recurrence or metastasis of papillary thyroid carcinoma

目的:分析甲状腺乳头状癌术后复发或转移的彩超及增强CT的影像表现,探讨两种方法对其的诊断价值。方法:回顾性分析54例疑似甲状腺乳头状癌术后复发或转移患者的病例资料,54例患者术前均行彩超及增强CT检查。以手术病理结果为"金标准",比较两种检查方法的诊断价值。结果:经病理确诊为甲状腺乳头状癌术后复发或转移45例,彩超诊断的灵敏度及准确性分别为93.3%、81.5%,高于增强CT诊断的75.6%、68.5%,差异有统计学意义(P<0.05)。45例复发病例复发时间以术后3个月~3年多见(68.9%),复发中位时间为30.5个月;转移部位以颈部最多见(86.7%)。结论:彩超是甲状腺乳头状癌术后复发或转移的首选检查方法,其敏感性及准确性高于增强CT,但CT也为诊断和治疗提供了有益的补充,应充分利用各自的优势,以达到准确诊断的目的;建议术后超声定期随诊至少3~5年。

Objective：To analyze the imaging characteristics of color Doppler ultrasound and contrast-enhanced CT in diagnosis of postoperative recurrence or metastasis of papillary thyroid carcinoma,and to explore the diagnostic value of the two methods.Methods：Clinical data of 54 cases who were suspected postoperative recurrence or metastasis of papillary thyroid carcinoma were analyzed retrospectively,all patients were diagnosed color Doppler ultrasound and contrast-enhanced CT before operation.Pathologic diagnosis was used as ＂gold standard＂ diagnosis the diagnostic value between two methods was compared.Results：Forty-five cases were diagnosed as postoperative recurrence or metastasis of papillary thyroid carcinoma by pathological diagnosis.The sensitivity and accuracy of color Doppler ultrasound were 93.3%and81.5%respectively,which were higher than those of contrast-enhanced CT 75.6% and 68.5%respectively,the difference was statistically significant（P〈0.05）.Postoperate recurrence of 45 cases often occurred between 3 months to 3 years after operation（68.9%）,and the average period was 30.5 months.Recurrent location often occurred incervical lymph node metastasis（86.7%）.Conclusion：Color Doppler ultrasound should be used as the first choice of imaging examination for postoperative recurrence or metastasis of papillary thyroid carcinoma,and its sensitivity and accuracy is higher than contrast-enhanced CT,but CT also provides the beneficial supplement for the diagnosis and treatment,should make full use of their advantages to improve the diagnostic accurary,ultrasound is recommended to be followed up for at least3-5 years after operation.