超声对甲状腺癌颈部淋巴结转移的诊断价值

Diagnostic value of Ultrasonography to metastasis of cervical lymph nodes in patients with thyroid carcinoma

目的探讨彩色多谱勒超声在甲状腺癌颈部淋巴结转移中的诊断价值。方法回顾性分析72例经手术病理证实为甲状腺癌患者的颈部淋巴结术前超声资料,记录肿大淋巴结分区、大小、二维声像图特征及内部血流状态等并与术后病理结果进行对照研究。结果转移性淋巴结超声检查与病理结果对照符合率为77.9%。淋巴结的长径/短径比值(L/S)<2、高回声淋巴门结构消失、内部见微钙化、囊性变及丰富血流预示淋巴结转移。转移性淋巴结组与良性增生性淋巴结组上述各指标比较,差异有统计学意义(P<0.05)。转移性淋巴结组收缩期峰值流速(PSV)和阻力指数(RI)均明显高于良性增生性淋巴结组(P<0.05)。结论高频彩色多普勒超声是诊断甲状腺癌颈部淋巴结转移的简便、有效的方法,诊断准确性较高,对临床有重要的指导意义。

Objective To investigate the diagnostic value of color doppler ultrasonography in the cervical lymph node metastases of thyroid carcinoma. Methods Preoperative ultrasonographic findings of 72 thyroid carcinoma patients confirmed by surgery and pathology were analyzed retrospectively. The locations,sizes,two-dimensional sonographic features and blood flow information of the lymph nodes were analysized by comparing with post-operative pathological results. Results The accordance rate was 77.9% between the ultras-onography and pathological results of metastatic lymph nodes.The metastasis existed in the lymph nodes with the sonographic features, which were a less than 2 ratio of long to short axis,absence of an echogenic hilum,microcalcification,cystis degeneration and affluent vascular pattern. The differences between the malignant and benign hyperplastic groups for all the above-mentioned index was statistically significant （P 0.05）. The blood flow peak systolic velocity （PSV） and resistance index （RI） in malignant groups were significantly higher than those in benign hyperplastic groups （ P 0.05）. Conclusion High-frequency color doppler ultrasound is convenient and effective in detecting metastatic lymph nodes in patients with thyroid carcinoma and has high diagnostic accuracy and important guiding significance in clinic.