甲状腺乳头状癌的常规超声及超声造影特征与淋巴结转移的相关性

目的 探讨常规超声（ultrasound，US）及超声造影（contrast-enhanced ultrasound，CEUS）特征和甲状腺乳头状癌（papillary thyroid carcinoma，PTC）淋巴结转移（lymph node metastasis，LNM）的相关性。方法 回顾性分析2018年在解放军总医院因超声可疑的单发性甲状腺结节而手术的患者，术前行常规二维超声检查及超声造影检查，记录患者年龄、性别及病灶的超声、CEUS特征，以手术病理结果为金标准，按是否发生淋巴结转移对PTC进行分组。采用单因素及多因素比较超声及超声造影特征在两组结节之间的差异。结果 共纳入293个结节，所有结节手术病理均诊断为甲状腺乳头状癌，其中LNM组134个，非LNM组159个；单因素分析显示，年龄、性别、常规超声指标中肿瘤最大径、结节回声、纵横比、肿瘤血流信号（color Doppler flow imaging，CDFI）、二维被膜外侵犯、超声可见可疑淋巴结，超声造影指标中增强程度、消退速度、造影被膜连续性等在两组之间，差异具有统计学意义。Logistic回归分析显示，男性（P<0.001）、年龄较小（P=0.008），常规超声指标中较大直径的肿瘤（P=0.017）、肿瘤彩色血流丰富（P=0.034），超声造影指标中被膜连续性中断（P=0.033）是其颈部淋巴结转移的独立危险因素。结论 常规超声及超声造影的部分特征和PTC淋巴结转移存在相关性，可能在预测淋巴结的转移中起到一定作用。

Correlation between conventional ultrasound and contrast-enhanced ultrasound and lymph node metastasis of papillary thyroid carcinoma

Objective To evaluate the correlation between the characteristics of ultrasound and contrast-enhanced ultrasound (CEUS) and lymph node metastasis of papillary thyroid carcinoma (PTC). Method A retrospective analysis was conducted on the patients who underwent surgery in the PLA General Hospital in 2018 due to suspicious single thyroid nodule. Routine two-dimensional ultrasound examination and CEUS examination were performed before surgery. Patients' age, gender, conventional ultrasound and CEUS characteristics of the lesions were recorded. The gold standard was based on the surgical pathological result. PTC nodules were divided into two groups according to the lymph node metastases (LNM) or not. Univariate and multivariate analyses were performed to compare the differences between ultrasonographic, CEUS characteristics and lymph node metastasis. Result A total of 293 nodules were enrolled in this study, which includes 134 nodules with LNM while 159 nodules without LNM. Univariate analyses shows statistically significant differences about patients' ages, gender, the maximum diameter of PTC nodule, echogenicity of the nodule, taller than wide, Color Doppler flow imaging(CDFI), capsule extension on ultrasound, ultrasound scanning suspicious LNM, enhancement pattern, homogeneity, wash-out speed, capsule extension on CEUS between the two groups. Logistic regression revealed that risk factors of cervical lymph node metastasis (CLNM) included young patients (P=0.008), male gender (P<0.001), large PTC nodule (P=0.017),rich blood flow in CDFI (P=0.034)and capsule extension on CEUS (P=0.033). Conclusion Some characteristics of ultrasound and CEUS are correlated with LNM of PTC, which may play a role in the prediction of LNM of PTC.