甲状腺癌颈部淋巴结转移高频超声的鉴别诊断价值

目的：探讨高频超声对甲状腺癌患者颈部肿大淋巴结转移的鉴别诊断价值。方法：对甲状腺癌患者颈部淋巴结进行评估,用高频超声诊断并测量淋巴结,记录形态、回声、大小、部位,结果由病理证实。结果：77例甲状腺癌患者中45例出现颈部淋巴结转移,绝大多数转移淋巴结为圆形,无淋巴门的低回声结节。淋巴结的形态对提示转移较为可靠,圆形、纵横径比小于2的低回声淋巴结常提示转移。在转移性病灶中无淋巴门,内部有囊变或钙化明显较良性多见。转移性淋巴结更多位于颈部下1/3处。结论：高频超声对甲状腺癌患者颈部肿大淋巴结转移有较高的诊断准确率,能为临床诊断、治疗提供参考。

Value of high frequency ultrasonographic differentiation of benign from malignant neck lymphadenopathy in thyroid carcinoma

Objective：To study the value of high frequency ultrasonographic differentiation of benign from malignant neck lymphadenopathy in thyroid carcinoma.Methods：We evaluated neck lymph nodes in patients with thyroid carcinoma.Nodes were detected and measured by high frequency ultrasonography,and their shape,echogenicity,size,and location were observed.Outcomes were determined by pathology reports.Results：Among 77 patients with thyroid carcinoma,45 patients had metastatic neck nodes.In most cases,metastases node had a round shape,with a hypoechoic nodes without a hilum,the shape of nodes seemed to be the most reliable in suggesting malignancy.A round shape with a longitudinal/transverse ratio of less than 2 of hypoechoic nodes indicated the presence of metastases.The absence of an echogenic hilum and the presence of cystic portions and calcifications were significantly greater in malignancies than in benign lesions.In most cases,metastatic nodules were situated in the lower one third of the neck.Conclusion：High frequency ultrasonography can provide valuable diagnostic information with a high degree of diagnostic accurate for neck lymphadenopathy in thyroid carcinoma.