超声对甲状腺癌颈部转移性淋巴结区域及特点的评价.pdfVIP

中华超声影像学杂志 2014 年 9 月第 23 卷第 9 期 ChinJ Ultrasonogr ,September 2014 ,Vol 23 ,No.9 • 769 • ·临床研究· 超声对甲状腺癌颈部转移性淋巴结区域及 特点的评价 黄丽燕何以放薛恩生陈志奎侯莹林礼务 【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% (1 67/290) , 其中中央区淋巴结转移者占 54.1 % (1 57/290) ，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/T2 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。 E关键词】 超声检查;甲状腺肿瘤;淋巴转移 UItrasound evaluation on cervical Iymph nodes metastasis regions and characteristics in thyroid carcinoma Huang Liyan , He Yin口 ， Xue Ensheng. Chen Zhikui , Hou Ying. Lin Liwu. Department of Ultrasound , Fujian Medical University Union Hospital ,Fuzhou 350001 ,China Corresponding authoγ :Lin Liu尉 .Email:llw0501@163.com [Abstract Objectíve 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 u !trasonography 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