超声造影对甲状腺癌颈部转移性淋巴结定位定性诊断的临床研究-外科学专业论文.docxVIP

重庆医科 重庆医科大学硕士研究生学位论文 万方数据 万方数据 英汉缩略语名词对照 英文缩写 CEUS 英文全称 Contrast-enhanced ultrasound 中文全称 超声造影 US Ultrasound 超声 Se Sensitivity 灵敏度 Sp Specificity 特异度 PPV Positive predictive value 阳性预测值 NPV Negative predictive value 阴性预测值 IONM Intraoperative neuromonitoring 术中神经监测 1 超声造影对甲状腺癌颈部转移性淋巴结 定位定性诊断的临床研究 摘要 目的：评价术前超声（ultrasound,US）超声造影(contrast-enhanced ultrasound,CEUS)对甲状腺癌颈淋巴结转移的定性定位诊断价值，指导 颈淋巴结手术清扫范围。方法：回顾性分析我院 242 例甲状腺癌患者 临床资料，术前均行 US、CEUS 检查，分别记录淋巴结在各区分布， 手术均行颈淋巴结分区域清扫，与术后病理进行比较。结果：US 对甲 状腺癌颈淋巴结转移诊断灵敏度为 30.8%，特异度为 89.0%，CEUS 对 甲状腺癌颈淋巴结转移诊断灵敏度为 62.7%，特异度为 94.5%，二者的 灵敏度相比差异有统计学意义（P=0.000）。CEUS 对各区域淋巴结诊 断阳性预测值最高为 VI 区 93.9%，其次依次为 II、III、IV 区，分别 是 92.3%、84.9%、80.4%，最低为 V 区 62.5%。CEUS 定位指导甲状 腺癌颈侧区手术范围准确率为 77.6%，US 的准确率为 63.8%。结论： CEUS 对颈部各区域转移性淋巴结定性定位诊断明显优于 US，可指导 临床手术方式及清扫范围。 关键词：超声造影，超声，甲状腺癌，转移性淋巴结 2 STUDY OF PREOPERATIVE CONTRAST-ENHANCED ULTRASOUND IN DIAGNOSING CERVICAL LYMPH NODE OF THYROID CANCER ABSTRACT Objective:To evaluate the clinical value of preoperative ultrasound(US) and contrast-enhanced ultrasound (CEUS) detection in diagnosing cervical lymph node metastasis of thyroid cancer and to determine the extent of lymph node dissection. Methods:We retrospectively analyzed 262 thyroid cancer patients’ clinical datas,all of the patients had thyroid US,CEUS and identification of the regions of cervical lymph node metastasis.All the patients had underwent cervical lymph node dissection,recorded the lymph nodes’ distributions.The pathology result were compared with those of US and CEUS. Results: The sensitivity of US in diagnosing the metastatic cervical lymph nodes of thyroid cancer was 30.8%,and the specificity was 89.0%. The sensitivity of CEUS in diagnosing the metastatic cervical lymph nodes of thyroid cancer was 62.7%,and the specificity was 94.5%.The sensitivity was statistically different between US and CEUS(P=0.000). The highest positive predictive value (PPV) of CEUS in diagnosing was region VI (93.9%),then in turn were region II(92.3%),III(84.9%