超声诊断甲状腺癌颈部淋巴结转移的价值分析

Value of Ultrasound in Diagnosis of Cervical Lymph Node Metastasis of Thyroid Carcinoma

目的:研究超声诊断甲状腺癌颈部淋巴结转移的价值。方法:选取2016年11月—2019年4月期间商丘市第一人民医院收治的甲状腺癌患者70例作为研究对象,术前采用超声仪检查颈部淋巴结,术后采用组织病理学检查,将临床病例检查结果为诊断金标准,测定诊断效能、颈部转移性淋巴结超声特征与诊断结果。结果:与未转移淋巴结比较,颈部淋巴结转移的阻力指数、内部回声不均匀、收缩期峰值速度、边界不清、纵径/横径<1.5与内部微钙化分值高;甲状腺癌颈部非转移性淋巴结27例,转移性淋巴结43例;超声检查准确67例,误诊2例,漏诊1例,准确率95.71%;病理检查准确59例,误诊7例,漏诊4例,准确率84.28%,与病理检查比较,超声检查准确率高,差异有统计学意义(P<0.05);病理检查显示,甲状腺癌颈部非转移性淋巴结28例,转移性淋巴结42例,其中单侧转移36例,双侧转移6例;超声检查显示,甲状腺癌颈部非转移性淋巴结27例,转移性淋巴结43例。结论:对甲状腺癌颈部淋巴结转移患者采用超声诊断能提高诊断准确率,便于为后续治疗提供重要参考依据,值得借鉴。

Objective: To study the value of ultrasonography in the diagnosis of cervical lymph node metastasis of thyroid cancer. Methods: 70 patients with thyroid cancer admitted to the hospital from November 2016 to April 2019 were selected as the research objects. The cervical lymph nodes were examined by ultrasound before operation, and histopathological examination after operation was adopted. The results of clinical cases were taken as diagnostic gold standard. The diagnostic efficacy, ultrasonographic characteristics and diagnostic results of cervical metastatic lymph nodes were determined. Results: Compared with non-metastatic lymph nodes, resistance index, internal echo heterogeneity, peak systolic velocity, unclear boundary, longitudinal/transverse diameter<1.5 and internal microcalcification score of cervical lymph node metastasis were higher. There were 27 cases of cervical nonmetastatic lymph nodes and 43 cases of metastatic lymph nodes of thyroid cancer. 67 cases were diagnosed accurately by ultrasonography, 2 cases were misdiagnosed, and 1 case was missed diagnosed. Accuracy rate was 95.71%. Pathological examination was accurate in 59 cases, misdiagnosis in 7 cases, and missed diagnosis in 4 cases. The accuracy rate was 84.28%. Compared with pathological examination, ultrasound examination was more accurate. The differences were statistically significant(P<0.05). Pathological examination showed 28 cases of non-metastatic lymph nodes in the neck of thyroid cancer, 42 cases of metastatic lymph nodes, including 36 cases of unilateral metastasis and 6 cases of bilateral metastasis. There were 27 non-metastatic lymph nodes and 43 metastatic lymph nodes in the neck of adenocarcinoma. Conclusion: Ultrasound diagnosis of cervical lymph node metastasis of thyroid cancer can improve the accuracy of diagnosis and provide important reference for follow-up treatment, which is worth learning.