超声诊断甲状腺乳头状癌颈部淋巴结转移的临床价值及其血流参数与淋巴结转移的相关性分析

The Clinical Value of Ultrasonography in Diagnosis of Cervical Lymph Node Metastasis of Thyroid Papillary Carcinoma and the Correlation between Blood Flow Parameters and Lymph Node Metastasis

目的:研究超声诊断甲状腺乳头状癌(PTC)颈部淋巴结转移的临床价值,并分析其血流参数与淋巴结转移的相关性。方法:选取2014年1月~2019年9月于我院接受诊治的78例PTC患者实施研究。按颈部淋巴结的转移情况将其分成转移组(42例)和非转移组(36例)。比较两组超声声像图特征,并分析超声诊断PTC颈部淋巴结转移的灵敏度、特异度、准确度。此外,对比两组彩色多普勒超声相关血流参数,分析彩色多普勒超声血流参数与淋巴结转移的相关性。结果:转移组淋巴门及纵横比≥2人数占比低于非转移组,而钙化、囊性变人数占比高于非转移组(均P<0.05)。以病理诊断为金标准,超声诊断PTC颈部淋巴结转移的灵敏度、特异度、准确度分别为95.24%、97.22%、96.15%。转移组与非转移组的收缩期加速时间(AT)对比差异无统计学意义(P>0.05);转移组收缩期峰值血流速度(PSV)、搏动指数(PI)、阻力指数(RI)均高于非转移组(均P<0.05)。经Pearson相关性分析可得:PSV、PI、RI与淋巴结转移均呈正相关关系(均P<0.05)。结论:超声诊断PTC颈部淋巴结转移的临床价值较高,且其血流参数与淋巴结转移存在密切相关,通过检测血流参数有利于判断患者的淋巴结转移。

Objective: To study the clinical value of ultrasonography in diagnosis of cervical lymph node metastasis of thyroid papillary carcinoma(PTC), and to analyze the correlation between blood flow parameters and lymph node metastasis. Methods: From January 2014 to September 2019, 78 patients with PTC who were treated in our hospital were selected for study. All subjects were divided into the metastatic group(42 cases) and the non-metastatic group(36 cases) according to cervical lymph node metastasis. The ultrasonographic image characteristics of the two groups were compared, and the sensitivity, specificity and accuracy of ultrasonographic diagnosis of PTC cervical lymph node metastasis were analyzed. In addition, the color doppler ultrasound blood flow parameters of the two groups were compared, the correlation between color doppler ultrasound blood flow parameters and lymph node metastasis was analyzed. Results: The proportion of lymphatic hilum and aspect ratio ≥2 in the metastatic group were lower than those in the non-metastatic group, while the proportion of calcification and cystic degeneration were higher than those in the non-metastatic group(all P<0.05). With pathological diagnosis as the gold standard, the sensitivity, specificity and accuracy of ultrasonic diagnosis of PTC cervical lymph node metastasis were 95.24%, 97.22% and 96.15%, respectively. There was no significant difference in acceleration time(AT)between the metastatic group and the non-metastatic group(P>0.05). Peak systolic velocity(PSV), pulsatility index(PI) and resistance index(RI) in the metastatic group were all higher than those in the non-metastatic group(all P<0.05). Pearson correlation analysis showed that PSV, PI and RI were positively correlated with lymph node metastasis(all P<0.05). Conclusion: Ultrasonography in diagnosis of PTC cervical lymph node metastasis is of high clinical value, and its blood flow parameters are closely related to lymph node metastasis. Detection of blood flow parameters is helpful to determine lymph node metastasis in patients with PTC.