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经包膜血流对评估中重度甲状腺外侵犯的意义:一项双中心研究结果

The Significance of Transcapsular Blood Flow for Assessing Moderate to Severe Extrathyroidal Extension: Results of a Two-Center Study.

作者信息

Li Zhi, Chen Shuqiang, Li Jinguo

机构信息

Health Management Center, The Second Affiliated Hospital of Fujian Traditional Chinese Medical University, Fuzhou, Fujian, People's Republic of China.

Ultrasound Department, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.

出版信息

Int J Gen Med. 2022 Feb 9;15:1341-1347. doi: 10.2147/IJGM.S349299. eCollection 2022.

DOI:10.2147/IJGM.S349299
PMID:35173472
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8841442/
Abstract

BACKGROUND

Extrathyroidal extension (ETE) is a crucial factor affecting the prognosis of thyroid cancer. Two-dimensional ultrasound is highly sensitive to ETE, but the sensitivity and specificity for severe ETE are unideal, so it does not improve the prognosis.

MATERIALS AND METHODS

This retrospective study evaluated patients within three years of subcapsular thyroid cancer diagnosis with fine-needle aspiration (FNA). Routine ultrasound was performed and examined before surgery. In addition to the traditional two-dimensional assessment method, particular attention was paid to transcapsular blood vessels, and the diagnostic efficacy of the two methods for mild, severe, and anterior and posterior ETE was compared.

RESULTS

A total of 208 thyroid cancer nodules were included. Tumor size and gender were correlated with whether ETE occurred. The general method is more accurate for the overall identification of ETE but is not specific enough for severe ETE, while the transvascular method is the opposite. The two are similar in identifying the ETE of the anterior capsule, but the transvascular method has higher specificity in identifying the ETE of the posterior capsule.

CONCLUSION

The traditional two-dimensional method is highly sensitive to ETE detection in the anterior capsule, while transcapsular blood flow can more effectively detect extensive ETE and ETE in the posterior capsule.

摘要

背景

甲状腺外侵犯(ETE)是影响甲状腺癌预后的关键因素。二维超声对ETE高度敏感,但对严重ETE的敏感性和特异性不理想,因此无法改善预后。

材料与方法

本回顾性研究评估了在诊断为甲状腺包膜下癌后三年内接受细针穿刺(FNA)的患者。术前进行常规超声检查。除了传统的二维评估方法外,特别关注穿包膜血管,并比较两种方法对轻度、重度以及前后方ETE的诊断效能。

结果

共纳入208个甲状腺癌结节。肿瘤大小和性别与ETE是否发生相关。常规方法对ETE的整体识别更准确,但对严重ETE的特异性不足,而穿血管方法则相反。二者在识别前包膜ETE方面相似,但穿血管方法在识别后包膜ETE方面具有更高的特异性。

结论

传统二维方法对前包膜ETE检测高度敏感,而穿包膜血流能更有效地检测广泛ETE及后包膜ETE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa85/8841442/8dd0de9ebdbb/IJGM-15-1341-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa85/8841442/f2d87fd9d3b3/IJGM-15-1341-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa85/8841442/8dd0de9ebdbb/IJGM-15-1341-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa85/8841442/f2d87fd9d3b3/IJGM-15-1341-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa85/8841442/8dd0de9ebdbb/IJGM-15-1341-g0002.jpg

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本文引用的文献

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Diagnostic performance of adult-based ATA and ACR-TIRADS ultrasound risk stratification systems in pediatric thyroid nodules: a systematic review and meta-analysis.基于成人的 ATA 和 ACR-TIRADS 超声风险分层系统在儿童甲状腺结节中的诊断性能:系统评价和荟萃分析。
Eur Radiol. 2021 Oct;31(10):7450-7463. doi: 10.1007/s00330-021-07908-8. Epub 2021 Apr 17.
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Impact of Gross Strap Muscle Invasion on Outcome of Differentiated Thyroid Cancer: Systematic Review and Meta-Analysis.
大体带状肌侵犯对分化型甲状腺癌预后的影响:系统评价与Meta分析
Front Oncol. 2020 Sep 25;10:1687. doi: 10.3389/fonc.2020.01687. eCollection 2020.
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Preoperative assessment of extrathyroidal extension of papillary thyroid carcinomas by ultrasound and magnetic resonance imaging: a comparative study.超声与磁共振成像对甲状腺外侵犯的甲状腺乳头状癌术前评估的对比研究。
Radiol Med. 2020 Sep;125(9):870-876. doi: 10.1007/s11547-020-01184-0. Epub 2020 Apr 5.
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