摘要
目的动态观察分化型甲状腺癌(DTC)术后可疑性淋巴结转移的超声声像变化。方法回顾性收集北票市中心医院2010-2015年收治的DTC术后出现可疑性淋巴结转移患者53例,记录首次检出可疑性淋巴结转移的声像特征;并继续以超声动态随访,观察可疑性淋巴结转移的声像变化。结果315例DTC患者,术后出现可疑性淋巴结转移占16.83%。首次检出时淋巴结大小:长径5~11 mm,平均(7.2±1.7)mm;短径3~7 mm,平均(4.2±1.1)mm。内部声像:点状增强占50.94%;局灶高回声占11.32%;囊性变7.55%。淋巴门声像:消失占83.02%。随访过程中,失访4例、退出8例、随访41例。41例患者淋巴结大小:基本不变占78.05%;增大占14.63%;变小占7.32%。内部声像变化:点状增强消失占25.93%;局灶高回声消失占33.33%;囊性变消失占25.00%。淋巴门声像变化:结构恢复占20.45%;维持消失占79.55%。8例退出随访者与首次检出可疑性淋巴结转移时相比,仅1例患者淋巴结增大,长径>10 mm;其余淋巴结内部和淋巴门声像未出现明显变化。结论大部分DTC患者术后颈部可疑性淋巴结转移在超声随访中未出现明显变化;对于可疑性淋巴结长径<10 mm者,可继续超声随访;而对于长径>10 mm者要警惕恶变。
Objective To dynamically observe the ultrasonographic changes of suspicious lymph node metastasis after operation for differentiated thyroid cancer(DTC).Methods A total of 53 patients with suspected lymph node metastasis after DTC in our hospital from 2010 to 2015 were retrospectively collected,and the sonographic features of suspected lymph node metastasis were recorded for the first time.The dynamic follow-up of ultrasound was continued to observe the sonographic changes of suspected lymph node metastasis.Results The 315 patients with DTC,16.83%had suspected lymph node metastasis after operation.The size of lymph nodes at the first detection was 5~11 mm in length,with an average of(7.2±1.7)mm,and 3~7 mm in short diameter,with an average of(4.2±1.1)mm.Internal sonography:punctate enhancement accounted for 50.94%;focal hyperechoicity accounted for 11.32%;cystic degeneration 7.55%.Lymphatic portal ultrasonography:disappearance accounted for 83.02%.During the follow-up,4 cases were lost,8 cases were withdrawn and 41 cases were followed up.The size of lymph nodes in 41 patients was basically unchanged(78.05%),increased(14.63%)and decreased(7.32%).Internal sonographic changes:punctate enhancement disappeared in 25.93%;focal hyperechoic disappeared in 33.33%;cystic degeneration disappeared in 25.00%.Ultrasonographic changes of lymphatic hilum:structural recovery accounted for 20.45%and maintenance disappearance accounted for 79.55%.Compared with the first detection of suspected lymph node metastasis,only one patient had enlarged lymph nodes with a diameter of more than 10 mm,and the other lymph nodes had significant changes in internal and lymphatic hilar ultrasonography.Conclusion Most patients with suspected neck lymph node metastasis after DTC have no significant changes in ultrasound follow-up.For those with suspected lymph node diameter less than 10 mm,ultrasound follow-up can be continued,while those with longer diameter more than 10 mm should be vigilant against malignant transformation.
作者
赵春颖
ZHAO Chunying(Department of Ultrasound,Beipiao Central Hospital,Beipiao 122100,Liaoning Province,China)
出处
《中国实用乡村医生杂志》
2019年第12期42-44,共3页
Chinese Practical Journal of Rural Doctor
关键词
甲状腺癌
分化型
淋巴结转移
可疑性
超声
随访
Thyroid Cancer
Differentiated Type
Lymph Node Metastasis
Suspicion
Ultrasound
Follow-up
