医学临床研究
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医学临床研究  2024, Vol. 41 Issue (5): 707-710    DOI: 10.3969/j.issn.1671-7171.2024.05.018
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多模态超声在甲状腺乳头状癌颈部淋巴结转移诊断中的临床应用价值*
黄小平, 吴丽, 林少鹏, 段若男, 李开林, 尹静
东莞东华医院,广东 东莞 523110
Clinical Application Value of Multimodal Ultrasound in Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma
HUANG Xiaoping, WU Li, LIN Shaopeng, et al
Dongguan Tungwah Hospital, Dongguan Guangdong 523110
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摘要 【目的】探讨多模态超声在甲状腺乳头状癌(PTC)颈部淋巴结转移诊断中的临床应用价值。【方法】回顾性分析2021年8月至2023年7月本院收治的90例PTC伴颈部淋巴结肿大患者的临床资料,所有入选者均进行二维超声(two dimensional ultrasound,DUS)、超声造影(contrast-enhanced ultrasound,CUES)、弹性超声成像技术(elastic ultrasound imaging technology,UE)检查。以病理结果为参考标准,分析DUS、CUES、UE单项检查与联合检查诊断PTC颈部淋巴结转移的灵敏度、特异度及准确度。分析PTC伴颈部淋巴结转移与未转移患者超声特征。【结果】90例PTC伴颈部淋巴结肿大患者病理结果显示,55例(61.11%)患者伴有颈部淋巴结转移,35例(38.89%)患者未出现颈部淋巴结转移。DUS、CUES、UE联合检查诊断PTC伴颈部淋巴转移的准确度为92.22%(83/90),明显高于DUS(73.33%)、CUES(80.00%)、UE(81.11%)单一检查,差异有统计学意义(P<0.05)。联合诊断灵敏度、特异度与CUES未见明显差异,但均高于DUS、UE单项检查,差异有统计学意义(P<0.05)。转移组患者血供模式、病灶组织所在区域、灌注均匀度、弹性评分、边缘规则及微钙化情况与未转移组比较,差异有统计学意义(P<0.05)。【结论】PTC颈部淋巴结转移临床诊断中应用多模态超声检查具有较高的诊断效能,临床需重视血供模式为周边血流型、病灶位于颈上部及中部、边缘不规则、微钙化等超声特征的病灶,以提高诊断准确性。
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关键词 甲状腺肿瘤/影像诊断乳头状瘤/影像诊断淋巴转移    
Abstract:【Objective】To explore the clinical application value of multimodal ultrasound in cervical lymph node metastasis of papillary thyroid carcinoma.【Methods】A retrospective analysis was conducted on the clinical data of 90 patients with PTC and cervical lymph node enlargement admitted to our hospital from August 2021 to July 2023. All selected patients underwent DUS CUES, UE inspection. Using pathological results as reference standards, DUS was analyzed Sensitivity, specificity, and accuracy of CUES and UE single and combined examinations in diagnosing cervical lymph node metastasis in PTC. The ultrasound characteristics of PTC patients with cervical lymph node metastasis and those without metastasis were analyzed.【Results】The pathological results of 90 patients with PTC and cervical lymph node enlargement showed that 55 patients (61.11%) had cervical lymph node metastasis, and 35 patients (38.89%) did not have cervical lymph node metastasis. The accuracy of DUS, CUES, and UE combined examination in diagnosing PTC with cervical lymph node metastasis was 92.22%(83/90), which was significantly higher than DUS (73.33%), CUES (80.00%) and UE(81.11%) single check, the difference was statistically significant (P<0.05). There was no significant difference in the sensitivity and specificity of joint diagnosis compared with CUES, but they were all higher than DUS, UE single item examination with statistically significant differences (P<0.05). The blood supply pattern, lesion tissue location, perfusion uniformity, elasticity score, edge regularity, and microcalcification of patients in the metastatic group were compared with those in the non metastatic group, and the differences were statistically significant (P<0.05).【Conclusion】The application of multimodal ultrasound in the clinical diagnosis of PTC cervical lymph node metastasis has high diagnostic efficacy. Clinical attention should be paid to lesions that exhibit peripheral blood flow patterns, lesions located in the upper and middle parts of the neck, irregular edges, microcalcifications, and other ultrasound features to improve diagnostic accuracy.
Key wordsThyroid Neoplasms/DG    Papilloma/DG    Lymphatic Metastasis
收稿日期: 2024-01-19     
中图分类号:  R736.1  
基金资助:*东莞市社会发展科技项目(编号:20211800901142)
引用本文:   
黄小平, 吴丽, 林少鹏, 段若男, 李开林, 尹静. 多模态超声在甲状腺乳头状癌颈部淋巴结转移诊断中的临床应用价值*[J]. 医学临床研究, 2024, 41(5): 707-710.
HUANG Xiaoping, WU Li, LIN Shaopeng, et al. Clinical Application Value of Multimodal Ultrasound in Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma. JOURNAL OF CLINICAL RESEARCH, 2024, 41(5): 707-710.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.05.018     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I5/707
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