甲状腺癌转移淋巴结的MRI诊断分析

Analysis on the MRI diagnosis of lymph node metastasis in thyroid carcinoma

目的分析甲状腺癌转移淋巴结的MRI表现、组织病理学特点,探讨MRI对甲状腺癌转移淋巴结的诊断价值。方法选取临床确诊甲状腺癌的患者30例,术前均行颈部MRI检查,标记可疑转移淋巴结,按颈部分区定位。同期行颈清扫术并将淋巴结分区送病理,标记MRI所示可疑淋巴结做病理对照,分析其MRI表现及主要特点。记录术后颈清扫标本中转移淋巴结的数量,将所得数据进行统计学分析。结果MRI标记淋巴结阳性率73.1%(98/134),阳性淋巴结检出率60.5%(98/162)。结论MRI检查能明确肿瘤是否侵犯周围组织器官及有无颈部淋巴结转移等,对临床分期评价及选择合适的治疗方案具有重要意义。

Objective It is to analyze the MRI manifestation and histopathological features of the lymph node metastasis in patients with thyroid carcinoma, and to investigate the diagnostic value of MRI in lymph node metastasis. Methods Thirty confirmed patients with thyroid carcinoma were chosen to accept preoperative MRI examination, and the suspectable nodes were marked and located to cervical compartment. Then the pathology of lymph nodes were located after neck dissection, and they were compared with the pathology of the marked suspectable nodes, and the manifestations and main feature of MRI were analyzed. All the pathologic specimens were reviewed by pathologists counting the numbers of pathologic positive nodes; the result was analyzed with statistics. Results The positive rate of MRI marked lymph nodes was 73.1% （98/134）, the pathology detection rate of lymph nodes metastases was 60.5 % （98/162）. Conclusion The examination of MRI is able to define whether the tumor has infiltrated the adjacent structures and whether there have metastatic lymphadenopathy on the neck or not. It is important for evaluating the clinical stage and choosing an appropriate treatment.