颈部增强CT在甲状腺癌发生颈部淋巴结转移患者中的诊断效果

Diagnostic effect of cervical contrast-enhanced CT on occurrence of cervical lymph node metastasis in patients with thyroid cancer

目的分析颈部增强CT对甲状腺癌颈部淋巴结转移的诊断效能。方法回顾性分析76例甲状腺乳头状癌患者的临床资料。以病理诊断结果为金标准,分析增强CT检查对甲状腺癌颈部淋巴结转移的诊断价值。结果病理学检查确诊本组患者颈部淋巴结转移153枚,未转移533枚,中央区淋巴结转60.13%;以病理诊断结果为金标准,增强CT诊断颈部中央区淋巴结转移准确率为83.61%,诊断颈侧区淋巴结转移准确率为89.26%;增强CT显示本组患者颈部转移淋巴结平均短径高于未转移淋巴结(8.91±2.62 mm vs 8.02±2.51 mm),转移与未转移淋巴结短径>10 mm、明显增强、明显不均匀强化、囊变、病灶内钙化及周围组织侵犯数目的差异有统计学意义(P<0.05)。结论增强CT对甲状腺癌颈部中央区淋巴结转移的诊断效能低于颈侧区淋巴结,建议结合超声或MRI检查综合评估。

Objective To analyze the diagnostic efficiency of cervical contrast-enhanced CT on cervical lymph node metastasis in thyroid cancer.Methods The clinical data of 76 patients with papillary thyroid carcinoma were retrospectively analyzed.Taking the pathological diagnosis result as the gold standard,the diagnostic value of contrast-enhanced CT examination on cervical lymph node metastasis in thyroid cancer was analyzed.Results Pathological examination confirmed 153 cervical lymph node metastases and 533 non-metastases,with 60.13%central lymph node metastasis.Taking pathological diagnosis as the gold standard,the accuracy rate of contrast-enhanced CT was 83.61%in diagnosing central cervical lymph node metastasis and was 89.26%in the diagnosis of lateral cervical lymph node metastasis.Contrast-enhanced CT showed that the average short diameter of cervical metastatic lymph nodes in patients was significantly higher than that in non-metastatic lymph nodes(8.91±2.62 mm vs 8.02±2.51 mm).There were significant differences between metastatic and non-metastatic lymph nodes in terms of short diameter>10 mm,obvious enhancement,obvious heterogeneous enhancement,cystic degeneration,calcification in the lesion and surrounding tissue invasion(P<0.05).Conclusion The diagnostic efficiency of contrast-enhanced CT for central cervical lymph node metastasis in thyroid cancer is lower than that in the lateral cervical lymph node metastasis.It is recommended to combine ultrasound or MRI for comprehensive evaluation.