彩色多普勒超声评价甲状腺乳头状癌颈部淋巴转移的价值

Value of color Doppler ultrasound in the evaluation of lymph node metastases in papillary thyroid carcinoma

目的探讨彩色多普勒超声下甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)颈部淋巴结转移的特征,分析其临床意义。方法选取于我院外科手术治疗并病理确诊的83例甲状腺乳头状癌患者,统计其彩色多普勒超声测量数据并分析淋巴结部位、形态、回声、大小,血供参数及血管情况等。按照病理诊断分为淋巴结转移组(31例)和淋巴结未转移组(52例),比较两组彩色多普勒超声的区别。结果①未转移组中纵横比≥2为41例占78.8%,转移组中纵横比<2为24例占77.4%。经比较发现,纵横比、淋巴门、囊性变、钙化在两组间的差异明显(P<0.05),具有统计学意义;②淋巴结未转移组和转移组的血管模式比较差异无统计学意义(P>0.05);③未转移组低血供35例(67.3%),转移组高血供16例(51.6%);未转移组PSV为(21.11±12.45)cm/s,RI为(0.61±0.09),转移组分别为(35.74±11.62)cm/s和(0.79±0.12);经比较发现,两组的血供程度、PSV、RI差异明显(P<0.05),具有统计学意义。结论诊断甲状腺癌颈部淋巴结转移需要多个临床指标进行综合判断,包括淋巴结形态、淋巴结门结构、内部回声、血流信号等,以更好的为临床治疗提供参考。

Objective To evaluate the features of lymph node metastases in papillary thyroid carcinoma （PTC） under color Doppler ultresound, and to analyze its clinical significance. Methods Eight-three PTC patients di- agnozed pathologically and treated by surgery in our hospital were enrolled in this study. The data of color Doppler ul- trasonic were analyzed, including the lymph node sites, shape, echo, size and blood supply parameters, and conditions of vessel. According to pathological dagnosis, the 83 patients were divided into two groups： group A （n=31, with lymph node metastases） and group B （n=52, without lymph node metastases）. The difference of color Doppler ultra- sound between the two groups were investigated. Results Forty-one patients （78.8%） in group B were found with as- pect ratio ≥ 2, and 24 patients （77.4%） in group A were found with aspect ratio 〈2. The aspect ratio, hilus, cystic disor- der and calcification showed statistically significant difference between the two groups （P〈0.05）, while the vessel model showed no statistically significant difference between the two groups （P〉0.05）. Thirty-five cases （67.3%） in group B and 16 cases （51.6%） in group A were found with low blood supply. The PSV and RI were （21.11 ~ 12.45） cm/s and （0.61＋0.09） in group B, （35.74~11.62） crn/s and （0.79~0.12） in group A. Statistically significant differece was found in blood supply, PSV, RT between the two groups （P〈0.05）. Conclusion Several clinical indicators should be evaluated for the diagnosis of lymph node metastases in papillary thyroid carcinoma, including lymph node shape, the structure of lymph node door, internal echo, flood flow signal.