高频超声联合CT在甲状腺乳头癌早期诊断及预测颈部淋巴结转移中的应用

Application of High-Frequency Ultrasound Combined with CT in Early Diagnosis of Papillary Thyroid Carcinoma and Prediction of Cervical Lymph Node Metastasis

目的探讨高频超声联合CT在甲状腺乳头癌(PTC)早期诊断及预测颈部淋巴结转移中的应用价值。方法回顾性分析2015年1月至2019年4月本院80例PTC患者高频超声与CT诊断影像学资料,以病理结果作为“金标准”,分析高频超声联合CT在甲状腺乳头癌早期诊断及淋巴结转移预测价值。结果80例PTC患者高频超声与CT扫描显示病灶形态与边缘异常、病灶内部异常、微钙化灶、粗大钙化、病灶淋巴结肿大方面比较(P>0.05);CT共检测出17例病灶血流异常,高频超声共检测出32例,高频超声病灶血流异常检出率高于CT(P<0.05);高频超声、CT联合检测与病理结果符合率(95.00%)高于单独高频超声检测(82.50%),高于单独CT诊断(85.00%);经术后病理诊断共包括颈淋巴结转移36例,未转移44例,高频超声共检测出真阳性28例,真阴性35例;CT共检测出真阳性27例,真阴性36例;联合检测共检测出真阳性34例,真阴性42例;联合检测预测颈部淋巴结转移准确度、敏感度、特异度、阳性预测值、阴性预测值分别为95.00%、94.44%、95.45%、94.44%、95.45%高于单独高频超声(78.75%、77.78%、79.55%、75.68%、81.40%),高于单独CT检测(78.75%、75.00%、81.82%、77.14%、80.00%,P<0.05)。结论高频超声联合CT在PTC早期诊断中具有较高的效能,可有效预测颈部淋巴结转移,效果优于单独检测。

Objective To explore application value of high-frequency ultrasound combined with CT in early diagnosis of papillary thyroid carcinoma(PTC)and prediction of cervical lymph node metastasis.Methods A retrospective analysis was performed on imaging data of high-frequency ultrasound and CT diagnosis from 80 PTC patients in the hospital from January 2015 to April 2019.Taking pathological results as"golden standard",value of high-frequency ultrasound combined with CT in early diagnosis of PTC and prediction of cervical lymph node metastasis was analyzed.Results Of 80 PTC patients,there were no significant differences in lesion shape and marginal abnormalities,internal lesion abnormalities,micro-calcification,calcification and lesion lymphadenectasis detected by high-frequency ultrasound and CT(P>0.05).It was detected out by CT that there were 17 lesions with abnormal blood flow,and 32 lesions detected by high-frequency ultrasound.The detection rate of abnormal blood flow by high-frequency ultrasound was higher than that by CT(P<0.05).The coincidence rate of high-frequency ultrasound combined with CT with pathological results was higher than that of high-frequency ultrasound and CT alone(95.00%vs.82.50%,85.00%).Postoperative pathological diagnosis showed that there were 36 cases with cervical lymph node metastasis and 44 cases without metastasis.It was detected out by high-frequency ultrasound that there were 28 cases of true positive and 35 cases of true negative.It was detected out by CT that there were 27 cases with true positive and 36 cases with true negative.It was detected out by high-frequency ultrasound combined with CT that there were 34 cases with true positive and 42 cases with true negative.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of combination detection for predicting cervical lymph node metastasis were(95.00%,94.44%,95.45%,94.44% and 95.45%),higher than those of high-frequency ultrasound and CT alone[(78.75%,77.78%,79.55%,75.68%,81.40%),(78.75%,75.00%,81.82%,77.14%,80.00%)](P<0.05).Conclusion High-frequency ultrasound combined with CT is of relatively higher efficiency in early diagnosis of PTC.It can effectively predict cervical lymph node metastasis,whose effect is better than that of single detection.