Zhang Ailong, Wu Shenglan, You Zhenhui, Liu Wenkai
Department of General Surgery, Fujian Provincial Hospital, Fuzhou, China.
Department of Ultrasonography, Jingzhou City Women and Children Hospital, Jingzhou, China.
Front Surg. 2022 Feb 28;9:851657. doi: 10.3389/fsurg.2022.851657. eCollection 2022.
The clinical value and application of preoperative ultrasound contrast in the diagnosis of cervical lymph node metastasis in thyroid papillary carcinoma is investigated.
In total, 126 cases of thyroid papillary carcinoma were selected, the sensitivity and accuracy of color ultrasound and ultrasound contrast were analyzed by comparing preoperative gray-scale ultrasound, color ultrasound, and ultrasound contrast.
The accuracies of preoperative color ultrasound and ultrasound contrast in detecting lymph node metastasis were 74 and 82%, respectively, and their sensitivities were 80 and 94%, respectively. Lymph node metastasis was significantly more severe when the tumor diameter was >4 cm. The lymphatic metastatic rate of the patients with multifocal papillary carcinoma was 96.4%, whereas the lymphatic metastatic rate of the patients with thyroid gland lesions was 87.7%. The central foci of cervical lymph node metastasis included the following pathological subtypes: diffuse sclerosis type (89.3%, 25/28), high-cell type (72.2%, 8/11), and papillary type (40.0%, 4/10).
Ultrasound contrast is more sensitive than color ultrasound in the diagnosis of cervical lymph node metastasis. Primary lesions ≥4 cm, lesion involvement, outer membrane, and high-risk pathologic subtypes and lesions were considered as the criteria for ultrasound contrast application.
探讨术前超声造影在甲状腺乳头状癌颈部淋巴结转移诊断中的临床价值及应用。
选取126例甲状腺乳头状癌患者，通过比较术前灰阶超声、彩色超声及超声造影，分析彩色超声和超声造影的敏感性及准确性。
术前彩色超声及超声造影检测淋巴结转移的准确率分别为74%和82%，敏感性分别为80%和94%。肿瘤直径>4 cm时，淋巴结转移明显更严重。多灶性乳头状癌患者的淋巴转移率为96.4%，而甲状腺腺叶病变患者的淋巴转移率为87.7%。颈部淋巴结转移的中央病灶包括以下病理亚型：弥漫硬化型（89.3%，25/28）、高细胞型（72.2%，8/11）和乳头状型（40.0%，4/10）。
超声造影在诊断颈部淋巴结转移方面比彩色超声更敏感。将原发灶≥4 cm、病变累及范围、外膜及高危病理亚型和病变作为超声造影应用的标准。
