甲状腺癌彩色血流平均密度检测对颈部淋巴结转移的预测价值

Mean color vessels density of thyroid carcinoma in predicting cervical lymph node metastasis

目的通过检测甲状腺癌患者甲状腺癌结节的彩色血流平均密度(MCVD),旨在评价其对颈部淋巴结转移的预测价值。方法选取76例甲状腺癌患者(甲状腺癌肿最大直径均>10mm),其中有淋巴结转移者50例(淋巴结转移组),无淋巴结转移者26例(无淋巴结转移组)。应用Adobe Photoshop CS5.0软件分析甲状腺癌结节能量多普勒图,计算两组患者甲状腺癌结节的MCVD,并通过ROC曲线分析取得最合适的临界值。结果有淋巴结转移组及无淋巴结转移组甲状腺癌结节的MCVD分别为0.27±0.05、0.18±0.06,差异有统计学意义(P<0.01)。ROC曲线分析得出最合适诊断临界点为0.22。以MCVD≥0.22为预测甲状腺癌有无颈部淋巴结转移的标准,其预测敏感性、特异性和准确性分别为90.0%(45/50)、80.8%(21/26)、86.8%(66/76)。结论甲状腺癌MCVD的检测可为预测颈部淋巴结的转移与否提供有价值的参考。

Objective To evaluate the mean color vessels density （MCVD） of thyroid carcinoma in predicting cervical lymph node metastasis. Methods Seventy six patients with thyroid carcinoma underwent color Doppler ultrasonography examination. The size of the tumors was 〉10mm in all patients, including 50 cases with cervical lymph node metastasis and 26 cases without cervical lymph node metastasis. The color Doppler power imagines （CDPt） of 76 lesions were analyzed with software Photoshop CS 5.0 and the MCVDs were calculated. With the ROC curve, the cutoff value of MCVD for prediction of lymph node metastasis was analyzed. Results The MCVD of cervical lymph node metastasis group was 0.27± 0.05, while that of non-cervical lymph node metastasis group was 0.18 ± 0.06（P〈0.01）. According to ROC curve analysis, using 0.22 as cutoff value of cervical lymph node metastasis, the sensitivity, specificity and accuracy of MCVD were 90.0% （45/50）, 80.8% （21/26） and 86.8% （66/76） respectively. Conclusion The detection of MCVD of thyroid carcinoma can provide valuable information in predicting cervical lymph node metastasis.