超声造影与超声弹性成像对老年甲状腺乳头状癌颈淋巴结转移诊断价值(1)
[摘要] 目的 探讨超声造影与超声弹性成像用于诊断老年甲状腺乳头状癌(PTC)颈淋巴结转移的临床应用价值。 方法 选择2015年5年～2017年5月解放军联勤保障部队第九〇三医院特诊科收治的117例老年PTC患者(183个结节)为研究对象。對其行超声造影与超声弹性成像检查，并以术后病理结果为金标准，依据PTC是否发生淋巴结转移，将其分为转移组45例(74个结节)和未转移组72例(109个结节)。比较两组超声造影定量参数和弹性应变率、弹性评分情况，比较超声造影、超声弹性成像及两者联合对PTC颈淋巴结转移诊断的准确率、特异性、灵敏度和阴性、阳性预测值，评估超声造影与超声弹性成像用于诊断老年PTC颈淋巴结转移的临床应用价值。 结果 转移组峰值强度高于未转移组，差异有统计学意义(P < 0.05);转移组弹性应变率高于未转移组，差异有统计学意义(P < 0.05);SR预测PTC颈淋巴结转移的曲线下面积大于PI;超声造影联合超声弹性成像诊断PTC颈淋巴结转移的准确率、灵敏度、阴性预测值均高于单独使用超声造影或超声弹性成像检测(P < 0.05)。结论 超声造影与超声弹性成像对PTC颈淋巴结转移具有一定的诊断价值，两者联合应用可有效提高诊断准确率，具有更高的临床应用价值。
[关键词] 超声造影;超声弹性成像;甲状腺乳头状癌;颈淋巴结转移
[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210(2020)06(a)-0151-05
[Abstract] Objective To evaluate the clinical application value of contrast-enhanced ultrasound and elastography in the diagnosis of cervical lymph node metastasis of elderly papillary thyroid carcinoma (PTC). Method A total of 117 elderly PTC patients (183 nodules) who admitted to Department of Special Diagnosis， 903rd Hospital of PLA from May 2015 to May 2017 were selected as the study objects. Contrast-enhanced ultrasound and ultrasound elastography were performed， and postoperative pathological results were used as the gold standard. According to whether PTC has lymph node metastasis， they were divided into metastasis group of 45 cases (74 nodules) and non metastasis group of 72 cases (109 nodules). Quantitative parameters， elastic strain rate and elastic score between the two groups were compared. The accuracy， specificity， sensitivity， negative and positive predictive value of contrast-enhanced ultrasound， elastography and their combination in the diagnosis of cervical lymph node metastasis of PTC were compared. The value of ultrasonography and elastography in the prediction of cervical lymph node metastasis of PTC were evaluated. Results The peak intensity of metastasis group was higher than that of non metastasis group， and the difference was statistically significant (P < 0.05). The elastic strain rate of metastasis group was higher than that of non metastasis group， and the difference was statistically significant (P < 0.05). SR predicted that the area under the curve of PTC cervical lymph node metastasis was greater than PI. The accuracy， sensitivity and negative predictive value of contrast-enhanced ultrasound combined with elastography in the diagnosis of cervical lymph node metastasis of PTC were higher than those of contrast-enhanced ultrasound or elastography alone. Conclusion Contrast-enhanced ultrasound and elastography have certain diagnostic value for cervical lymph node metastasis of PTC. The combination of them can effectively improve the diagnostic accuracy and has higher clinical application value., 百拇医药(邬一峰 余秀华 胡君)
[关键词] 超声造影;超声弹性成像;甲状腺乳头状癌;颈淋巴结转移
[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210(2020)06(a)-0151-05
[Abstract] Objective To evaluate the clinical application value of contrast-enhanced ultrasound and elastography in the diagnosis of cervical lymph node metastasis of elderly papillary thyroid carcinoma (PTC). Method A total of 117 elderly PTC patients (183 nodules) who admitted to Department of Special Diagnosis， 903rd Hospital of PLA from May 2015 to May 2017 were selected as the study objects. Contrast-enhanced ultrasound and ultrasound elastography were performed， and postoperative pathological results were used as the gold standard. According to whether PTC has lymph node metastasis， they were divided into metastasis group of 45 cases (74 nodules) and non metastasis group of 72 cases (109 nodules). Quantitative parameters， elastic strain rate and elastic score between the two groups were compared. The accuracy， specificity， sensitivity， negative and positive predictive value of contrast-enhanced ultrasound， elastography and their combination in the diagnosis of cervical lymph node metastasis of PTC were compared. The value of ultrasonography and elastography in the prediction of cervical lymph node metastasis of PTC were evaluated. Results The peak intensity of metastasis group was higher than that of non metastasis group， and the difference was statistically significant (P < 0.05). The elastic strain rate of metastasis group was higher than that of non metastasis group， and the difference was statistically significant (P < 0.05). SR predicted that the area under the curve of PTC cervical lymph node metastasis was greater than PI. The accuracy， sensitivity and negative predictive value of contrast-enhanced ultrasound combined with elastography in the diagnosis of cervical lymph node metastasis of PTC were higher than those of contrast-enhanced ultrasound or elastography alone. Conclusion Contrast-enhanced ultrasound and elastography have certain diagnostic value for cervical lymph node metastasis of PTC. The combination of them can effectively improve the diagnostic accuracy and has higher clinical application value., 百拇医药(邬一峰 余秀华 胡君)