超声联合18F-FDG PET/CT对甲状腺乳头状癌术后复发转移的诊断价值

Value of color Doppler ultrasound combined with F-FDG PET/CT in diagnosis of postoperative recurrence and/or metastasis in papillary thyroid carcinoma

目的:探讨彩色多普勒超声联合18F-FDG PET/CT对甲状腺乳头状癌术后复发和(或)淋巴结转移的临床诊断价值。方法:回顾并分析45例疑似甲状腺乳头状癌术后复发和(或)淋巴结转移患者的影像学检查资料,与病理学检查结果对照,分析比较彩色多普勒超声与18F-FDGPET/CT联合应用、单纯应用彩色多普勒超声及单纯应用PET/CT的临床诊断价值。结果:45例患者中病理学检查结果显示甲状腺乳头状癌术后复发和(或)转移34例,其中单纯局部复发5例,单纯淋巴结转移19例,局部复发合并淋巴结转移10例。彩色多普勒超声联合18F-FDG PET/CT对甲状腺乳头状癌术后复发和(或)转移诊断的灵敏度、特异度、准确率显著高于单纯应用彩色多普勒超声及单纯应用18F-FDGPET/CT,差异有统计学意义(P<0.05)。结论:彩色多普勒超声联合18F-FDG PET/CT能显著提高对甲状腺乳头状癌术后复发和(或)淋巴结转移诊断的准确率,降低漏诊误诊率,尤其是颈部以外区域转移的病灶,两者联合具有重要的临床应用价值。

Objective:To evaluate the value of color Doppler ultrasound(US)combined with 18F-FDG PET/CT in the diagnosis of postoperative recurrence or lymph node metastasis in papillary thyroid carcinoma.Methods:Clinical data of 45 cases who were suspected recurrence and/or lymph node metastasis in papillary thyroid carcinoma were analyzed retrospectively.All cases confirmed by pathology were compared with the diagnostic value between US combined with PET/CT and US,US combined with PET/CT and PET/CT.Results:A total of 34 cases were diagnosed as recurrence and/or lymph node metastasis in papillary thyroid carcinoma postoperative by pathological diagnosis,and 5 cases were local recurrence,and 19 cases were only lymph node metastasis,and 10 cases were local recurrence with lymph node metastasis.The sensitivity,specificity,accuracy of US combined with PET/CT was significantly higher than those of simple US and simple PET/CT,and the difference was statistically significant(P<0.05).Conclusion:US combined with 18F-FDG PET/CT can improve the diagnostic sensitivity and accuracy in the diagnosis of postoperative recurrence or lymph node metastasis in papillary thyroid carcinoma,reduce the rate of misdiagnosis,especially for patients with suspected lymph node metastasis of infrequently involved levels.There is the important clinical value of US combined with 18F-FDG PET/CT in the diagnosis of postoperative recurrence or lymph node metastasis in papillary thyroid carcinoma.