高频彩超对甲状腺癌颈部淋巴结转移诊断价值的探讨

Value of high frequency color doppler ultrasound in the diagnosis of cervical lymph node metastasis of thyroid carcinoma

目的:探讨高频彩超对甲状腺癌患者颈部淋巴结转移的诊断价值。方法:回顾性分析65例甲状腺癌患者术前甲状腺和颈部淋巴结的超声表现,比较转移性淋巴结和非转移性淋巴结在二维超声和彩色多普勒超声的表现。结果:转移和非转移淋巴结组间淋巴结纵横比<1.5、边缘缺损、内部回声欠均匀以及微钙化等超声指标差异均有统计学意义,P<0.05。转移淋巴结中血流分布较丰富,多普勒血流收缩期峰值流速(Vmax)和阻力指数(RI)也高于非转移淋巴结,P<0.05。肿瘤>2 cm组、肿瘤边界不清或锯齿状的颈部淋巴结转移发生率明显增高,P<0.05;颈部淋巴结转移组较未转移组病灶内彩色血流信号丰富,P<0.05;而肿瘤内是否出现钙化与甲状腺癌是否发生颈部淋巴结转移无相关性,P>0.05。结论:高频彩超对术前甲状腺癌颈部淋巴结转移具有重要的诊断价值。

OBJECTIVE： To explore the value of high frequency color doppler ultrasound in the diagnosis of cervical lymph node metastasis of thyroid carcinoma.METHODS： The characteristics of sonography in lymph nodes of 65 patients with thyroid cancer were analyzed retrospectively.The appearance of benign lymph and malignant lymph in B mode and Colour Doppler sonography and the relationship between the metastatic lymph and the primary lesion were compared.RESULTS： The differences of the sonographic manifestations of the lymph nodes included long/ short axis（〈1.5）,the node envelop,hilum and calcifications in node between lymph node metastasis group and no-lymph node metastasis group were significant（P〈0.05）.Vmax and RI in lymph node metastasis group were higher than that of no-lymph node metastasis group（P〈0.05）.The rate of lymph node metastasis in the size of thyroid carcinoma 〉2 cm group,no-integrated node envelope group and full color flow signals group significantly increase（P〈0.05）.The color blood signal in lymph node metastasis group was more than that in no metastasis group（P〈0.05）.There was no correlation between calcifications in node and lymph node metastasis（P〉0.05）.CONCLUSION： High-frequency ultrasound has important value in diagnosis and diferential diagnosis of cervical lymph nodes enlargement in patients with thyroid cancer.