摘要
目的 探讨超声诊断甲状腺癌颈部淋巴结转移区域及特点的价值.方法 回顾性分析经病理证实的290例甲状腺癌患者的术前声像图表现,对颈部淋巴结转移区域的超声与病理诊断进行对比,并评价其超声表现特点.结果 290例甲状腺癌患者术后病理证实颈部淋巴结转移者占57.6％（167/290）,其中中央区淋巴结转移者占54.1％（157/290）,明显高于颈侧区的20.7％（60/290）;术前超声诊断颈部淋巴结转移者占63.8％（185/290）,其中对颈侧区的诊断阳性率为57.6％,显著高于中央区的31.7％（P＜0.05）;但颈侧区的超声诊断特异性仅为35.9％,明显低于中央区的72.8％（P＜0.05）.甲状腺癌颈部转移性淋巴结的超声特点以类圆形及淋巴门消失多见,内部呈低回声或伴钙化、团状高回声、囊性改变,其中中央区多以L/T＜2为主.结论 甲状腺癌最易转移至颈部中央区淋巴结,超声对其诊断的特异性高但敏感性低,因此提高超声对中央区淋巴结的诊断率有重要的临床意义.
Objective To investigate the value of ultrasonic diagnosis on cervical lymph nodes metastasis regions and characteristics in thyroid carcinoma.Methods Ultrasound image of 290 patients with thyroid carcinoma were analyzed restrospectively.The cervical lymph node metastasis regions diagnosed by ultrasonography were compared with histopathologic results,and the ultrasound characteristics of metastasis lymph nodes were assessed.Results Among 290 patients,167 cases with cervical lymph node metastasis were comfirmed by pathology （57.6%）,and 185 cases were detected by pre-operative ultrasound （63.8%）.The region of thyroid carcinoma lymph node metastasis comfirmed by histopathology was most commonly the central region （54.1%）,followed by the lateral neck （20.7%）.The diagnostic rate of central region lymph node metastatic by pre-operative ultrasound was only 31.7%,which was sharply lower than that of lateral region （57.6%,P 〈0.05）.However,the diagnostic specificity （72.8 %） was apparently higher than lateral region （35.9%,P 〈0.05）.The ultrasonic characteristics of metastatic cervical lymph nodes included rounded shape,absence of echogenic hilus,presence of calcitication,hyperechogenicity and cystic change.Conclusions The cervical central region is the predominant region for thyroid carcinoma lymph node metastasis,and ultrasound diagnosis on central region lymph node metastasis possesses positive specificity but negative sensitivity.Improving ultrasound diagnostic accuracy on central lymph nodes metastasis would be of important clinical significance.
出处
《中华超声影像学杂志》
CSCD
北大核心
2014年第9期769-772,共4页
Chinese Journal of Ultrasonography
关键词
超声检查
甲状腺肿瘤
淋巴转移
Ultrasonography
Thyroid neoplasms
Lymphatic metastasis
