实时弹性超声在诊断甲状腺癌转移性颈部淋巴结中的运用价值

Application value of real-time elastic ultrasound in the diagnosis of metastatic cervical lymph nodes of thyroid carcinoma

目的探究实时弹性超声应用于甲状腺癌转移性颈部淋巴结中的诊断价值。方法 89例甲状腺癌转移性颈部淋巴结患者均行实时弹性超声及常规超声探查,并对比常规超声与弹性超声的诊断结果。结果 89例患者中未分化癌3例、髓样癌2例、滤泡状癌4例、乳头状癌80例;其中转移性淋巴结157枚,未分化癌28枚、髓样癌6枚、滤泡状癌8枚、乳头状癌115枚,未转移淋巴结114枚。常规超声诊断甲状腺癌颈部淋巴结转移与否中,形态方面比较差异无统计学意义(P>0.05);血流、纵横比、短轴及内部回声在非转移淋巴结与转移淋巴结中比较差异具有统计学意义(P<0.05)。常规超声的灵敏度75.79%、阴性预测值72.85%低于实时弹性超声95.54%、93.51%,比较差异具有统计学意义(P<0.05)。结论实时弹性超声用于转移性颈部淋巴结诊断可提高诊断准确性与灵敏度。

Objective To explore the value of real - time elastic ultrasound in the diagnosis of metastatic cervical lymph nodes of thyroid carcinoma. Methods A total of 89 thyroid cancer patients with metastatic cervical lymph nodes all received real-time elastic ultrasound and conventional ultrasound exploration, and the diagnosis results of conventional ultrasound and elastic ultrasound were compared. Results Among 89 patients, there were 3 cases of undifferentiated carcinoma, 2 cases of medullary carcinoma, 4 cases of follicular carcinoma, 80 cases of papillary carcinoma, which including 157 metastatic lymph nodes, 28 undifferentiated carcinomas, 6 medullary carcinomas, 8 follicular carcinomas and 115 papillary carcinomas, and 114 lymph nodes without metastasis. There was no statistical significant difference in morphology by conventional ultrasound in diagnosis of metastatic cervical lymph nodes of thyroid carcinoma （P〉0.05）; there were statistically significant difference in blood flow, aspect ratio, short axis and internal echo in non metastatic lymph node and metastatic lymph node （P〈0.05）. The conventional ultrasound had sensitivity as 75.79% and negative predictive value as 72.85%, which were lower than that of the real-time elastic ultrasound 95.54% and 93.51%, and their difference had statistical significance （P〈0.05）. Conclusion Real-time elastic ultrasound can improve diagnostic accuracy and sensitivity in the diagnosis of metastatic cervical lymph nodes.