超声造影对甲状腺癌颈部转移性淋巴结的定性分析

Qualitative Analysis of Cervical Metastatic Lymph Nodes in Thyroid Cancer by Contrast-enhanced Ultrasound

目的探讨超声造影(CEUS)对甲状腺癌颈部转移性淋巴结的定性价值。方法采用回顾性、总结研究方法,选择颈部淋巴结病变患者80例作为研究对象,病理诊断为甲状腺癌颈部转移性淋巴结患者40例(转移组)和淋巴瘤患者40例(淋巴瘤组)。所有患者都给予常规超声与CEUS诊断,记录定性诊断效果。结果转移组的淋巴结长径、短径显著短于淋巴瘤组(P <0. 05),2组长短径比值差异无统计学意义(P <0. 05)。相对于淋巴瘤组,转移组CEUS主要表现为造影模式混合性、造影剂分布不均匀与存在无灌注区,对比差异有统计学意义(P <0. 05)。转移组的MTT值显著高于淋巴瘤组(P <0. 05),2组PI、TTP与AT值对比差异无统计学意义(P> 0. 05)。CEUS诊断为甲状腺癌颈部转移性淋巴结42例,淋巴瘤38例,CEUS对甲状腺癌颈部转移性淋巴结的定性敏感性与特异性为97. 5%和92. 5%。结论CEUS对甲状腺癌颈部转移性淋巴结的定性诊断有很好的价值,可给临床医生提供客观、直观的造影信息,具有重要的临床诊断价值。

Objective To evaluate the qualitative diagnostic value of contrast-enhanced ultrasound( CEUS) in cervical metastatic lymph nodes in thyroid cancer. Methods Retrospective and summary methods were used,80 patients with cervical lymph node lesions were selected as the study subjects,and 40 patients( metastatic group) and 40 patients( lymphoma group)with cervical lymph node metastasis of thyroid cancer were pathologically diagnosed. All patients were given routine ultrasound and CEUS diagnosis,and the results of qualitative diagnosis were recorded. Results The length and diameter of lymph nodes in the metastatic group were significantly lower than those in the lymphoma group( P < 0. 05),and there were no significant difference in the short diameter ratio compared between the 2 groups( P < 0. 05). Compared with the lymphoma group,the CEUS in the metastatic group were mainly characterized by the mixed contrast pattern,the inhomogeneous distribution of contrast media and the non perfusion area,and compared the difference were statistically significantly( P < 0. 05). The MTT value of the metastatic group were significantly higher than that of the Lymphoma Group( P < 0. 05),there were no significant difference in PI,TTP and AT compared between the 2 groups( P > 0. 05). CEUS were diagnosed as 42 cases of cervical metastatic lymph nodes in thyroid cancer and 38 cases of lymphoma. The qualitative sensitivity and specificity of CEUS to cervical metastatic lymph nodes in thyroid cancer were 97. 5% and 92. 5%. Conclusion CEUS is of great value for the qualitative diagnosis of cervical metastatic lymph nodes in thyroid cancer. It can provide an objective and visual information to clinicians,and it is of great value in clinical diagnosis.