甲状腺癌颈部淋巴结转移的超声表现及对临床治疗的意义

目的:分析甲状腺癌颈部淋巴结转移的超声表现,探讨转移淋巴结的声像图特征、分布及对临床治疗的指导意义。方法:回顾性分析50例甲状腺癌患者126枚颈部转移淋巴结的超声表现及分布,所有病灶均经手术或超声引导下穿刺活检证实。分析转移淋巴结的长短径比值、边界、皮质厚度、淋巴门、内部囊性变、内部钙化、Adler血流分级、峰值流速(peak systolic velocity,PSV)、RI,并与40枚反应增生性淋巴结对比。结果:转移淋巴结长短径比值较小、边界欠清、皮质增厚、淋巴门高回声消失、内部可见囊性变及钙化、Adler血流分级及PSV均较高,与反应增生性淋巴结相比差异有统计学意义。结论:甲状腺癌颈部淋巴结转移具有特征性超声表现,其准确诊断及定位有助于指导患者的治疗。

The ultrasonographic manifestations of metastatic cervical lymph nodes in thyroid carcinoma and evaluation of its clinical significance to treatment

Objective： To analyze the ultrasonographie manifestations of metastatic cervical lymph nodes in thyroid carcinoma, and evaluate its distribution,clinical significance of treatment and the location of sentinel lymph node. Methods：The ultrasonographic features and distribution of 126 metastatic cervical lymph nodes in 50 patients with thyroid carcinoma were studied retrospectively, all the lesions were confirmed by operation or fine-needle aspiration. Analyze the length diameter ratio, boundary, cortical thickness, hilar,internal cystic change, calcification inside, adler flow grade, peak flow velocity （PSV）, resistance index （RI） and compare to 40 benign reactive hyperplasia lymph nodes. Results.. Metastatic lymph nodes had lower length diameter ratio, unclear boundary, thickened cortex, disappeared hilar, internal cystic change, calcification inside, higher Adler flow grade and peak flow velocity （PSV）. Compared with reactive hyperplasia lymph nodes these manifestations were significantly differ- ent. Conclusion：The ultrasonographic features of metastatic lymph nodes of thyroid carcinoma are characteristic,its accurate diagnosis and location has the guiding significance for clinical significance of treatment.