淋巴造影增强US诊断甲状腺癌颈部淋巴结转移价值分析

Value of enhanced lymphography in the diagnosis of cervical lymph node metastasis in thyroid carcinoma

目的:探讨淋巴造影增强超声(US)诊断甲状腺癌(TC)颈部淋巴结转移的效能。方法:选取2022年6月—2024年5月沛县人民医院收治并经手术病理确诊的63例TC患者为研究对象,于术前均接受常规US检查和淋巴造影增强US检查,以手术病理结果为金标准,分析常规US与淋巴造影增强US对TC颈部淋巴结转移的诊断价值以及TC转移颈部淋巴结造影增强US的影像学特征。结果:手术病理结果显示,63例TC患者中29例出现颈部淋巴结转移(含43个转移淋巴结)、34例未出现颈部淋巴结转移(含38个良性淋巴结)。以手术病理结果为金标准,81个淋巴结中,常规US检出64个(未检出的17个淋巴结归为良性淋巴结进行统计),灵敏度为74.42%、特异度为73.68%、诊断符合率为74.07%;淋巴造影增强US检出81个,灵敏度为95.35%、特异度为84.21%、诊断符合率为90.12%。淋巴造影增强US诊断TC颈部淋巴结转移的灵敏度、诊断符合率高于常规US(P<0.05),而特异度与常规US差异无统计学意义(P>0.05)。TC转移颈部淋巴结造影增强US影像学特征主要表现为均匀增强型和规则环状增强型。结论:淋巴造影增强US可提高TC患者颈部淋巴结转移的诊断率,能够为临床治疗提供指导。

Objective To investigate the efficacy of enhanced lymphography ultrasonography(US)in the diagnosis of cervical lymph node metastasis in thyroid carcinoma(TC).Methods 63 TC patients admitted to Peixian People's Hospital from June 2022 to May 2024 and confirmed by surgery and pathology were selected as the study objects.All of them underwent routine US examination and enhanced lymphography US examination before surgery,and the surgical pathological results were taken as the gold standard,to analyze the diagnostic value of conventional US and enhanced lymphography US in TC cervical lymph node metastasis and the imaging features of enhanced US in TC cervical lymph node metastasis.Results Surgical pathological results showed that 29 of the 63 TC patients had cervical lymph node metastasis(including 43 metastatic lymph nodes)and 34 had no cervical lymph node metastasis(including 38 benign lymph nodes).Using surgical pathological results as the gold standard,64 out of 81 lymph nodes were detected by routine US(17 lymph nodes that were not detected were classified as benign lymph nodes for statistics),with sensitivity of 74.42%,specificity of 73.68%and diagnostic coincidence rate of 74.07%.81 cases were detected by US enhanced lymphography,the sensitivity was 95.35%,the specificity was 84.21%,and the diagnostic coincidence rate was 90.12%.In the diagnosis of TC cervical lymph node metastasis,the sensitivity and diagnosis coincidence rate of lymphography enhanced US were higher than that of conventional US(P<0.05),but the specificity was not significantly different from that of conventional US(P>0.05).The US imaging features of cervical lymph node contrast enhancement with TC metastasis were mainly uniform enhancement type and regular annular enhancement type.Conclusion Enhanced lymphography with US can improve the diagnosis rate of cervical lymph node metastasis in TC patients and provide guidance for clinical treatment.