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超声造影与传统超声在诊断甲状腺乳头状癌伴颈部淋巴结转移中的价值

Value of Contrast-enhanced Ultrasound and Conventional Ultrasound in the Diagnosis of Papillary Thyroid Carcinoma with Cervical Lymph Node Metastases.

作者信息

Zhang Yan, Luo Yukun, Zhang Mingbo, Yang Ming, Zhang Ying, Li Junlai, Tang Jie

机构信息

Department of Ultrasound,Chinese PLA General Hospital,Beijing 100853,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017 Apr 20;39(2):177-182. doi: 10.3881/j.issn.1000-503X.2017.02.003.

Abstract

Objective To compare the ultrasound features of papillary thyroid carcinoma with or without cervical lymph node metastasis (LNM). Methods Patients suspected of thyroid cancer underwent the conventional ultrasound and contrast-enhanced ultrasound (CEUS) examinations. Patients' age,sex,and ultrasound characteristics of lesions were recorded. With the surgical pathology as the golden standard,the ultrasound features were compared between the cervical LNM group and non-LNM group. Results Of 144 patients,51 had cervical LNM and 93 did not. Patients' ages,sex and number of lesions had no significant difference between two groups (all P>0.05). Tumor with LNM had maximum size greater than 0.85 cm,ill-defined margin (P=0.000),irregular shape (P=0.007),internal heterogeneous echogenicity (P=0.007),microcalcification (P=0.020),internal heterogeneous low-enhancement (P=0.002),peripheral non-enhancement ring (P=0.030),and extracapsular extension (P=0.000). Conclusion Conventional ultrasound and CEUS are helpful for predicting the cervical LNM of PTC. CEUS can obtain more accurate diagnostic results for the extracapsular extension,which contributes to the prediction of cervical LNM.

摘要

目的 比较有或无颈部淋巴结转移(LNM)的甲状腺乳头状癌的超声特征。方法 对疑似甲状腺癌的患者进行常规超声和超声造影(CEUS)检查。记录患者的年龄、性别及病变的超声特征。以手术病理作为金标准,比较颈部LNM组和非LNM组的超声特征。结果 144例患者中,51例有颈部LNM,93例无。两组患者的年龄、性别及病变数量差异均无统计学意义(均P>0.05)。有LNM的肿瘤最大径大于0.85 cm,边界不清(P=0.000),形态不规则(P=0.007),内部回声不均匀(P=0.007),微钙化(P=0.020),内部不均匀低增强(P=0.002),周边无增强环(P=0.030),及包膜外侵犯(P=0.000)。结论 常规超声和CEUS有助于预测PTC的颈部LNM。CEUS对包膜外侵犯可获得更准确的诊断结果,有助于颈部LNM的预测。

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