高频超声联合超声弹性成像对PTC淋巴结转移的诊断价值

Diagnostic value of high-frequency ultrasound combined with ultrasound elastography in lymph node metastasis of PTC

目的:分析高频超声(HFU)联合超声弹性成像(UE)对甲状腺乳头状癌(PTC)淋巴结转移的诊断价值。方法:选取112例PTC患者作为研究对象,所有患者均接受HFU及UE检查,以术后病理结果为依据,根据淋巴结转移情况分为非转移组(n=75)与转移组(n=37),比较两组HFU特征、UE参数(弹性应变率、蓝色面积比值),采用受试者工作特征(ROC)曲线分析HFU联合UE诊断淋巴结转移的价值。结果:转移组血流信号丰富、纵横比≥1、微钙化、侵犯被膜占比分别为72.97%、81.08%、72.22%、80.00%,均高于非转移组的21.33%、26.32%、24.68%、24.00%(P<0.05);转移组弹性应变率、蓝色面积比值均高于非转移组(P<0.05);ROC曲线显示,血流信号、纵横比、微钙化、侵犯被膜、弹性应变率及蓝色面积比值联合诊断PTC淋巴结转移的AUC为0.904,高于六者单独诊断的AUC:0.758、0.772、0.725、0.758、0.765、0.743(P<0.05)。结论:PTC淋巴结转移患者HFU主要表现为血流信号丰富、纵横比≥1、微钙化及侵犯被膜,UE参数明显增加,联合对PTC淋巴结转移具有较高的诊断效能。

Objective:To explore the diagnostic value of high-frequency ultrasound(HFU)combined with ultrasound elastography(UE)in lymph node metastasis of papillary thyroid carcinoma(PTC).Methods:A total of 112 patients with PTC undergoing underwent HFU and UE examinations were selected as the study subjects.Based on postoperative pathological results,the non-metastasis group(n=75)and metastasis group(n=37)were evaluated based on lymph node metastasis.HFU characteristics and UE parameters(elastic strain rate,blue area ratio)were compared.The receiver operating characteristic curve(ROC)was used to analyze the value of HFU combined with UE in diagnosing lymph node metastasis.Results:The proportions of abundant blood flow signals,aspect ratio≥1,micro-calcification and membrane invasion in metastasis group were 72.97%,81.08%,72.22%and 80.00%,which were higher than those in non-metastasis group(21.33%,26.32%,24.68%,24.00%,P<0.05),elastic strain rate and blue area ratio were also higher than those in non-metastasis group(P<0.05).ROC curves analysis showed that AUC of blood flow signal combined with aspect ratio,micro-calcification,membrane invasion,elastic strain rate and blue area ratio was 0.904,greater than that of single index(0.758,0.772,0.725,0.758,0.765,0.743,P<0.05).Conclusion:In patients with PTC and lymph node metastasis,main manifestations of HFU include abundant blood flow signal,aspect ratio≥1,micro-calcification and membrane invasion,and UE parameters are significantly increased.The combined detection of HFU and UE has high diagnostic efficiency for lymph node metastasis in PTC.