中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2017, Vol. 39 ›› Issue (2): 177-182.doi: 10.3881/j.issn.1000-503X.2017.02.003

• 论著 • 上一篇    下一篇

对比增强超声与常规超声在判断甲状腺乳头状癌颈部淋巴转移中的意义

张艳, 罗渝昆(), 张明博, 杨明, 张颖, 李俊来, 唐杰   

  1. 中国人民解放军总医院超声科,北京 100853
  • 收稿日期:2016-09-28 出版日期:2017-04-20 发布日期:2017-04-20
  • 作者简介:

    通信作者:罗渝昆 电话:010-66939533,电子邮件:lyk301@163.com

  • 基金资助:
    国家自然科学基金(81471681)和解放军总医院临床科研扶持基金(2015PC-TSYS-2022)

Value of Contrast-enhanced Ultrasound and Conventional Ultrasound in the Diagnosis of Papillary Thyroid Carcinoma with Cervical Lymph Node Metastases

Yan ZHANG, Yukun LUO(), Mingbo ZHANG, Ming YANG, Ying ZHANG, Junlai LI, Jie TANG   

  1. Department of Ultrasound,Chinese PLA General Hospital,Beijing 100853,China
  • Received:2016-09-28 Online:2017-04-20 Published:2017-04-20
  • Supported by:
    Supported by the National Natural Sciences Foundation of China (81471681) and the Clinical Research Support Foundation of PLA General Hospital (2015PC-TSYS-2022)

摘要:

目的 对比分析颈部淋巴结转移(LNM)组与无LNM组甲状腺乳头状癌(PTC)超声特征的差异。方法 对怀疑为甲状腺癌并拟行手术切除的患者进行常规超声检查及超声造影(CEUS)检查,记录患者年龄、性别及病灶超声特征。以手术病理结果为金标准,比较上述特征在LNM组与非LNM组之间的差异。结果 共144例患者,其中51例伴颈部LNM,93例不伴LNM。年龄、性别、病灶数目在LNM组与非LNM组之间的差异无统计学意义(P>0.05)。LNM组癌灶最大径大于0.85 cm,边界不清(P=0.000),形态不规则(P=0.007),内部回声不均匀(P=0.007),伴有微钙化(P=0.020),内部不均匀低增强(P=0.002),周边不规则无增强环(P=0.030)及包膜侵犯(P=0.000)。结论 常规超声及CEUS特征可为预测PTC是否发生颈部LNM转移提供有效帮助,特别是CEUS对病灶包膜外侵犯的评估较准确,对LNM的预测有重要意义。

关键词: 甲状腺癌, 超声, 病灶, 超声造影

Abstract:

Objective To compare the ultrasound features of papillary thyroid carcinoma with or without cervical lymph node metastasis (LNM). Methods Patients suspected of thyroid cancer underwent the conventional ultrasound and contrast-enhanced ultrasound (CEUS) examinations. Patients’ age,sex,and ultrasound characteristics of lesions were recorded. With the surgical pathology as the golden standard,the ultrasound features were compared between the cervical LNM group and non-LNM group. Results Of 144 patients,51 had cervical LNM and 93 did not. Patients’ ages,sex and number of lesions had no significant difference between two groups (all P>0.05). Tumor with LNM had maximum size greater than 0.85 cm,ill-defined margin (P=0.000),irregular shape (P=0.007),internal heterogeneous echogenicity (P=0.007),microcalcification (P=0.020),internal heterogeneous low-enhancement (P=0.002),peripheral non-enhancement ring (P=0.030),and extracapsular extension (P=0.000). Conclusion Conventional ultrasound and CEUS are helpful for predicting the cervical LNM of PTC. CEUS can obtain more accurate diagnostic results for the extracapsular extension,which contributes to the prediction of cervical LNM.

Key words: thyroid cancer, ultrasound, lesion, contrast-enhanced ultrasound

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