磁共振成像对伴颈部淋巴结转移的甲状腺乳头状癌的价值评估

The value assessment of magnetic resonance imaging for thyroid pap illary carcinoma in the neck lymph node metastases

目的探讨甲状腺乳头状癌(PTC)的磁共振成像(MRI)成像特征及其与颈部淋巴结转移的关系。方法对112例患者共120个PTC结节的术前MRI平扫、增强图像进行分析,根据病理有无颈部淋巴结转移分为转移组49例和对照组63例,主要观察癌结节的位置、大小、数量、形态、边缘、信号特征、强化程度及特点。探讨各MRI成像特征与颈部淋巴结转移间的关系。结果癌结节最大径越大,颈部淋巴结转移率越高(P<0.05);癌结节位于峡部,颈部淋巴结转移率高(P<0.05);癌结节侵犯包膜,颈部淋巴结转移率高(P<0.05);癌结节纵横比、边缘、信号特征、强化方式对评估颈部淋巴结转移无统计学意义(P>0.05)。结论 PTC大小、病灶位置及是否侵犯包膜与颈部淋巴结转移关系密切,对术前评估PTC是否有颈部淋巴结转移具有重要价值。

Objective To evaluate magnetic resonance imaging （MRI） features of thyroid papillary carcinoma papillary thyroid carcinoma （PTC） and its relationship with cervical lymph node metastasis. Methods Based on preoperative magnetic resonance imaging （MRI） and enhance image for 112 cases of patients with a total of 120 PTC nodules, all cases were divided into transfer group of 49 cases and control group of 63 examples according to the pathological presence of neck lymph node metastasis. Mainly to observe carcinoma nodules＇ location, size, number, shape, characteristics, signal characteristics, strengthening degree and the edges. The relationship between MRI imaging and cervical lymph node metastasis was discussed. Results The higher the maximum size of the tubercle was, the higher the lymph node transfer rate was （P〈0.05）. When cancer nodules were located in the isthmus, the transport rate of the cervical lymph nude was higher （P〈0.05）; When the cancer nodules infringed the envelop , the transport rate of the cervical lymph node was higher （P〈0.05）; Cancer nodular aspect ratio, edge, signal feature, and reinforcement method were not statistically significant for assessing cervical lymph node metastasis （P〉0.05）. Conclusion The PTC size, the location of the lesion, and whether the envelope is associated with the cervical lymph node metastases, are important to assess whether PTC has a cervical lymph node transfer before surgery.