超声成像对乳头状甲状腺癌颈部淋巴结转移的诊断价值

目的 探讨超声成像对乳头状甲状腺癌(PTC)颈部淋巴结转移的诊断价值.方法 回顾性分析132例PTC患者的临床资料,通过建立Logistic回归模型分析超声成像对PTC颈部淋巴结转移的诊断价值,应用受试者工作特征(ROC)曲线分析超声成像相关指标诊断PTC患者发生颈部淋巴结转移的准确度.结果 以颈部淋巴结清扫术病理学检查结果作为金标准,132例PTC患者中,共有49例PTC患者发生颈部淋巴结转移,颈部淋巴结转移率为37.1%,淋巴结内囊性变、甲状腺包膜被累及程度、收缩期峰值血流速度(PSV)、阻力指数(RI)与PTC患者发生颈部淋巴转移的关系最为密切,ROC曲线下面积分别为0.813、0.926、0.895和0.902,预测PTC颈部淋巴结转移的准确度分别为90.75%、94.83%、92.46%和92.47%.结论 超声成像诊断PTC颈部淋巴结转移与病理诊断结果吻合度高,其中,淋巴结内囊性变、甲状腺包膜被累及程度、PSV和RI对预测PTC颈部淋巴转移具有较高的诊断价值.

Ultrasound imaging in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma

Objective To investigate the value of ultrasound imaging in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma (PTC).Method The clinical data of 132 patients with PTC were retrospectively analyzed,the Logistic regression model was established to analyze the value of ultrasound imaging in the diagnosis of cervical lymph node PTC,and the receiver operating characteristic (ROC) curve was used to analyze the accuracy of ultrasound imaging related index for diagnosis of PTC in patients with cervical lymph node metastasis.Result Taking the cervical lymph node dissection and pathological results as the gold standard,out of total 132 patients,49 cases of PTC patients with cervical lymph node metastasis,the lymph node metastasis rate was 37.1%.Cystic changes of the lymph node,thyroid capsule involvement degree,peak systolic velocity (PSV) and resistance index (RI) were the indexes that mostly correlated with the occurrence of cervical lymph node metastasis in PTC patients.The areas under the curves in ROC test for the above indexes were 0.813,0.926,0.895 and 0.902,respectively,and the corresponding predictive accuracies of these indexes on cervical lymph node metastasis in PTC patients were 90.75% ,94.83% ,92.46% and 92.47% .Conclusion The diagnosis of ultrasound imaging is consistent with pathological findings,among all the indexes,cystic change of the lymph nodes,the degree of involvement of the thyroid membrane,PSV and RI,which are of high value in the prediction of cervical lymph node metastasis in PTC.