超声结合针吸活检在判断甲状腺癌术后颈部淋巴结复发转移中的应用价值

目的 评价超声结合超声引导下细针抽吸细胞学检查在甲状腺癌术后颈部淋巴结转移中的诊断价值.方法 对132例甲状腺癌术后患者的148枚淋巴结行超声检查,同时对淋巴结在超声引导下行细针抽吸细胞学检查,分析甲状腺癌术后颈部淋巴结的超声特征表现.结果 148枚淋巴结中有119枚淋巴结为转移性.占穿刺淋巴结的80.4%,非转移性淋巴结29枚,占19.6%.转移性淋巴结中有34.5%出现在Ⅲ组,有40.3%出现在Ⅳ组.转移性淋巴结表现为类圆形,呈等回声或偏高回声结节,回声分布不均匀,淋巴结内部有钙化,血流信号2～3级.若根据超声表现为短轴/长轴〉0.5,回声分布不均,淋巴结内部有钙化,淋巴结内血流信号2～3级其病理诊断为转移性和非转移性两组间比较,差异有统计学意义（P〈0.01）.结论 甲状腺癌术后颈部转移淋巴结在形态、内部回声结构及血流分布等方面有较为特征性表现,同时结合超声引导下的细针抽吸细胞学检查可对颈部淋巴结的病理性质作出正确判断.

Ultrasonography with FNAC in evaluation of lymph node metastasis in thyroid carcinoma

Objective To evaluate the ultrasonography （US） agnosis of lymph node metastasis in thyroid carcinoma. Methods combined with fine-needle aspiration cytology （FNAC） in diOne hundred and forty-eight cervical lymph nodes from 132 patients with thyroid carcinoma were studied by US with FNAC after thyroidectomy, and the ultrasonic feature was analyzed. Re- sults Of 148 lymph nodes examined, 119 （80.4%） were metastatic. In all metastatic nodes 34.5% was located in III region, and 40.3% in IV region. On ultrasonography the metastatic nodes appeared round shape; they showed equal or high-level and maldistribution echo, calcification inside, and the blood flow was classified as degree 2- 3. According to above ultrasonic characteristics,metastatic lymph nodes significantly differed from non-metastatic ones （P〈0.01）. Conclusion Ultrasonography combined with FNAC is useful in diagnosis of cervical lymph node metastasis in thyroid carcinoma.