论文部分内容阅读
目的探讨超声在甲状腺癌颈部淋巴结转移的诊断价值。方法回顾分析了超声检查经手术证实的检出淋巴结的甲状腺癌患者42例。二维及彩色多普勒超声对上述患者主要观察颈部淋巴结的数目、纵横比、形态、边界、内部回声、有无微小钙化、内部血流状态等。结果42例患者中超声共探及颈部淋巴结89枚。病理诊断甲状腺癌淋巴结转移的为73枚,非淋巴结转移的为11枚。超声诊断淋巴结转移的符合率为82.0%(73/89),非淋巴结转移的符合率为87.5%(14/16)。淋巴结的纵横比<1.5(84.9%)、淋巴结内部的回声不均(75.3%)、淋巴结的边界欠规则(74.0%)、淋巴结内可见微小钙化(32.9%)。转移性和非转移性淋巴结组间上述超声指标的差异均具有统计学意义(P<0.05)。转移性淋巴结血流分布较丰富,多普勒血流速度(PSV)和阻力指数(RI)也高于非转移淋巴结(P<0.05)。结论超声是诊断甲状腺癌颈部淋巴结转移的一种简便、有效的方法,研究结果对指导临床准确进行超声诊断和提高诊疗水平具有重要意义。
Objective To investigate the diagnostic value of ultrasound in cervical lymph node metastasis of thyroid cancer. Methods A retrospective analysis of 42 cases of thyroid cancer detected by ultrasonography was performed. Two-dimensional and color Doppler ultrasound in patients with the main observation of the number of cervical lymph nodes, aspect ratio, morphology, boundary, internal echo, with or without micro-calcification, internal blood flow status. Results Among the 42 patients, there were 89 ultrasound scans and cervical lymph nodes. Pathological diagnosis of thyroid cancer lymph node metastasis was 73, non-lymph node metastasis of 11. The coincidence rate of ultrasound diagnosis of lymph node metastasis was 82.0% (73/89), and the non-lymph node metastasis coincidence rate was 87.5% (14/16). The aspect ratio of lymph nodes was less than 1.5 (84.9%), uneven echoes within lymph nodes (75.3%), irregular boundary of lymph nodes (74.0%) and microcalcifications (32.9%) in lymph nodes. The differences of the above ultrasonic indexes between metastatic lymph node group and non-metastatic lymph node group were statistically significant (P <0.05). Metastatic lymph node blood flow distribution is more abundant, Doppler flow velocity (PSV) and resistance index (RI) than non-metastatic lymph nodes (P <0.05). Conclusion Ultrasound is a simple and effective method for the diagnosis of cervical lymph node metastasis of thyroid cancer. The results of the study are of great importance to guide the clinical diagnosis of ultrasound and improve the diagnosis and treatment.