摘要
目的:通过回顾性分析甲状腺癌颈部淋巴结转移病例,探讨彩超对颈部淋巴结转移的诊断价值。方法:抽取本院2009年6月-2014年6月彩超诊断甲状腺癌颈部淋巴结转移并行颈部淋巴结清扫术的病例63例,统计转移淋巴结纵横比<2、淋巴门结构消失、点状强回声、融合淋巴结、囊性变、血流信号、边界以及转移区域等出现的百分比,并与增生淋巴结上述特征进行对比。结果:63例病例中术后病理检查证实为颈部淋巴结转移61例,彩超综合诊断符合率为96.8%。纵横比<2敏感度82.95%,特异度为75.26%;淋巴门结构消失敏感度75.97%,特异度为89.13%;点状强回声敏感度51.94%,特异度为96.07%;融合淋巴结敏感度27.91%,特异度为100%;囊性变敏感度34.88%,特异度为84.56%,转移淋巴结上述彩超特点与增生淋巴结相比差异有统计学意义(P<0.05)。而转移淋巴结丰富的血流信号及边界不清则与增生淋巴结差异无统计学意义。转移区域在Ⅳ、Ⅲ、Ⅵ、Ⅴ区较为多见(94.5%),Ⅱ、Ⅰ区转移率相对较少(5.5%),差异有统计学意义(P<0.01)。结论:彩超提示淋巴结纵横比<2、淋巴门结构消失、具有点状强回声、融合淋巴结、囊性变在甲状腺癌颈部淋巴结转移诊断中具有重要价值。
Objective To explore the diagnostic value of color Doppler ultrasound for cervical lymph node metastasis in pa- tients with thyroid carcinoma by retrospectively analyzing the clinical data. Methods From June 2009 to June 2014,63 pa- tients with thyroid carcinoma diagnosed by color Doppler ultrasound were selected, and all the patients occured cervical lymph node metastasis and underwent lymph node dissection. The incidence rates of those metastatic lymph nodes aspect ra- tio 〈 2, disappeared structttre of hilus, dotted dense echo, fusion of lymph nodes, cystic degeneration, blood flow signals, the margin of lymph nodes and metastatic area were statistically analyzed,as well as comparatively analyzed the above character- istics with hyperplasia lymph node. Results In all 63 patients ,61 cases of cervical lymph node metastasis were confirmed by pathology pestoperation. The diagnostic coincidence rate of color Doppler ultrasound was 96.8%, the sensitivity and speci- ficity of aspect ratio 〈 2 were 82.95% and 75.26% ,respectively. The sensitivity and specificity of disappeared structure of hilus were 75.97% and 89. 13%, respectively. The sensitivity and specificity of dotted dense echo were 51.94% and 96.07%, respectively. The sensitivity and specificity of fusion lymph nodes were 27.91% and 100%, respectively. The sen- sitivity and specificity of cystic degeneration were 34.88% and 84.56%, respectively. The above characteristics of color Doppler ultrasound between hyperplasia lymph nodes and metastatic lymph nodes were significant differences （ P 〈 0.05 ）. The abundant blood flow signals and obscure boundary of metastatic lymph nodes had no significant difference compared with those of hyperplasia lymph nodes. The percentages of metastatic area was high to 94.5% and mainly focus on district Ⅱ, Ⅲ, Ⅴ and Ⅵ, but only 5.5% on district Ⅱ and I Conclusion The characteristics of aspect ratio 〈 2, disappeared structure of hilus, dotted dense echo, fusion of lymph node may play important roles in diagno
出处
《湖北医药学院学报》
CAS
2015年第2期155-158,F0004,共5页
Journal of Hubei University of Medicine
关键词
甲状腺癌
颈部淋巴结转移
彩超
Thyroid carcinoma
Cervical lymph node metastasis
Color Doppler ultrasound
