彩色多普勒超声对甲状腺乳头状癌颈部淋巴结囊性转移的诊断价值

Diagnostic value of color doppler ultrasound in cervical lymph nodes cystic metastases of papillary thyroid carcinoma

目的探讨甲状腺乳头状癌颈部淋巴结囊性转移的超声表现。方法对经病理证实为甲状腺乳头状癌颈部淋巴结囊性转移的18例患者,44枚囊性转移性淋巴结进行高频彩色多普勒超声检查,观察其二维声像图,结节、分隔内部的血流情况。结果囊性转移性淋巴结二维声像图表现为完全囊性变和部分囊性变两种类型,42枚为部分囊性变,2枚为完全囊性变。其中38枚囊性变区透声差,39枚囊壁较厚且毛糙,23枚有壁结节,18枚内部有粗细不均分隔,19枚内部见点状高回声,40枚囊性转移性淋巴结实性成分内见点状、条状血流信号。结论彩色多普勒超声是诊断甲状腺乳头状癌颈部淋巴结囊性转移的一项重要检查方法,颈部淋巴结囊性变对于甲状腺乳头状癌转移的诊断有较高的特异性。

Objective To explore the sonographic characteristics of cervical lymph nodes cystic metastases of papillary thyroid carcinoma. Methods Eighteen patients with cervical lymph nodes cystic metastases of papillary thyroid carcinoma were confirmed by pathology, and 44 cervical cystic metastatic lymph nodes were examined by color Doppler ultrasound. 2 - dimensional ultrasound and blood supply of nodules and internal septations were observed. Results The 2 - dimensional ultrasound of cystic metastatic lymph nodes were completely cystic and partly cystic. 42 cervical cystic metastases lymph nodes were partly cystic and only 2 were completely cystic. The sonographic features of these were as follows ： heterogeneously echo free in 38 lesions, presence of a thickened and coarse outer wall in 39 lesions, internal nodules in 23 lesions, internal septations in 18 lesions, punctiform highlevel echo in 19 lesions, and blood supply of nodules and septations in 40 lesions. Conclusion Color Doppler ultrasound is an important method in diagnosing cervical lymph nodes cystic metastases of papillary thyroid carcinoma, and cystic lymph nodes has high specificity in diagnosing papillary thyroid carcinoma metastasis.