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目的评价甲状腺乳头状癌中央区淋巴结转移的CT特点及探讨CT在甲状腺乳头状癌中央区淋巴结转移术前评估中的作用。方法回顾性分析149例甲状腺乳头状癌行中央区淋巴结清扫患者的临床资料,术前均行颈部CT平扫+增强,并与术后病理比较。结果 149例甲状腺乳头状癌患者中,CT可见的淋巴结共350枚。病理诊断有中央区淋巴结转移的99例患者可见292枚淋巴结,其中13枚有钙化,200枚有包膜外侵犯,146枚有淋巴结强化,48枚有坏死,其淋巴结短径和长径的平均值分别为6.5 mm和8.5 mm。病理诊断无中央区淋巴结转移的50例患者中,33例可见58枚淋巴结,无一枚有钙化,7枚有包膜外侵犯,9枚有淋巴结强化,8枚有坏死,其淋巴结短径和长径的平均值分别为4.4 mm和6.1 mm。CT诊断甲状腺乳头状癌中央区淋巴结有无转移的灵敏度为100%,特异度为34.0%。结论有无钙化、包膜外侵、强化及坏死及淋巴结的长短径是CT诊断甲状腺乳头状癌中央区淋巴结转移的重要指标,严格应用这些指标对甲状腺乳头状癌的患者进行术前评估,对诊断有无中央区淋巴结转移有一定帮助。
Objective To evaluate the CT features of lymph node metastasis in the central region of thyroid papillary carcinoma and to explore the role of CT in the preoperative evaluation of lymph node metastasis in the central region of papillary thyroid carcinoma. Methods The clinical data of 149 patients with papillary thyroid carcinoma who underwent lymph node dissection in the central region were retrospectively analyzed. The neck CT scan and enhancement were performed preoperatively and compared with postoperative pathology. Results Of the 149 cases of thyroid papillary carcinoma, there were 350 lymph nodes visible in CT. Pathological diagnosis of central lymph node metastasis in 99 patients showed 292 lymph nodes, of which 13 were calcified, 200 with extracapsular invasion, 146 with lymph node enhancement, 48 with necrosis, the average short diameter and long diameter lymph nodes The values are 6.5 mm and 8.5 mm respectively. Pathological diagnosis of central lymph node metastasis in 50 patients, 33 cases of visible 58 lymph nodes, no calcification, 7 with extracapsular invasion, 9 with lymph node enhancement, 8 with necrosis, and its short diameter lymph nodes and The average major diameter is 4.4 mm and 6.1 mm, respectively. CT diagnosis of papillary thyroid carcinoma in the central lymph node metastasis with a sensitivity of 100%, a specificity of 34.0%. Conclusions The presence or absence of calcification, extracapsular invasion, enhancement and necrosis, and the length and breadth of lymph nodes are important markers for the diagnosis of lymph node metastasis in the central region of papillary thyroid carcinoma. The patients with thyroid papillary carcinoma should be evaluated preoperatively Diagnosis of central lymph node metastasis has some help.