| 摘要: |
| 目的： 探讨超声造影（CEUS）在预测甲状腺乳头状癌（PTC）颈部淋巴结转移中的价值。
方法： 回顾性分析64例患者71个PTC结节的CEUS资料，以术后病理结果为依据将PTC结节分为颈部淋巴结转移组和颈部淋巴结未转移组，利用QLAB软件进行CEUS定量分析，绘制PTC结节边缘区及中央区的时间-强度曲线（TIC），计算上升时间（RT）、峰值强度（PI）、平均渡越时间（MTT）、曲线下面积（AUC）、峰值降半时间（TPH）、上升斜率（WIS）和达峰时间（TTP），对比分析两组PTC结节的CEUS灌注强度特征及定量参数差异并绘制相关参数受试者工作特征曲线（ROC）。
结果：71个PTC结节CEUS灌注强度特征在颈部淋巴结转移组与颈部未转移组之间无统计学差异（P＞0.05）。颈部淋巴结转移组PTC结节边缘区PI、AUC分别为（8.39±2.19）dB、（220.69±83.56）dB s，颈部淋巴结未转移组PTC结节边缘区PI、AUC分别为（6.52±2.32）dB、（168.29±52.95）dB s，转移组结节边缘区PI、AUC大于未转移组（P＜0.01）。两组PTC结节边缘区及中央区RT、MTT、TPH、WIS、TTP 之间均无统计学差异（P＞0.05），两组PTC结节中央区PI、AUC之间均无统计学差异（P＞0.05）。PTC结节边缘区PI、AUC判断颈部淋巴结转移的曲线下面积分别为0.733、0.708，当PTC结节边缘区PI临界值＞8.04 dB及AUC临界值＞202.99 dB s时，判断颈部淋巴结转移的敏感性、特异性分别为67.6%、82.4%和64.9%、79.4%。
结论： 颈部淋巴结转移组PTC结节边缘区CEUS定量参数PI、AUC显著大于颈部淋巴结未转移组，PTC结节边缘区CEUS定量参数PI、AUC对预测PTC颈部淋巴结转移具有一定的临床应用价值。 |
| 关键词: 甲状腺乳头状癌 淋巴结转移 超声造影 定量参数 边缘区 |
| DOI： |
| 投稿时间：2017-10-24修订日期：2018-06-22 |
| 基金项目:扬州市科技计划社会发展面上项目（YZ2017085） |
|
| The Value of Contrast-enhanced Ultrasonography in Predicting Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma |
| shiyanyun,qitingyue |
| (The Affiliated Hospital Of Yangzhou University) |
| Abstract: |
| Purpose To evaluate the value of contrast-enhanced ultrasonography(CEUS) in predicting cervical lymph node metastasis of papillary thyroid carcinoma.
Methods The CEUS data of seventy-one PTC nodules of sixty-four patients was analyzed retrospectively. The PTC nodules were divided into cervical lymph node metastasis group and non-cervical lymph node metastasis group on the basis of pathological findings. Time-intensity curve(TIC) of the peripheral and central area of each nodules was drawn using QLAB software.After that, CEUS quantitative parameters were obtained as follows: the rise time(RT),the peak intensity(PI),the mean transit time(MTT),the area under the curve (AUC),the time from peak to one half (TPH), the wash in slope(WIS) and the time to peak(TTP). The CEUS perfusion intensity characteristics and quantitative parameters of PTC nodules in the two groups were compared and analyzed, as well as the receiver operating curve(ROC) of the quantitative parameters were drawn.
Results There was no significant difference between the metastasis group and non-metastasis group in the perfusion intensity features of the seventy-one PTC nodules(P＞0.05).The PI and AUC in the peripheral area of the metastasis group were (8.39±2.19)dB and (220.69±83.56)dB s respectively, Accordingly, which were (6.52±2.32)dB and (168.29±52.95)dB s, respectively in the non-metastasis group. The PI and AUC in the peripheral area of the metastasis group were significantly higher than those in the non-metastasis group(P＜0.01).However,the RT.MTT.TPH.WIS.TTP in both peripheral and central areas were not significantly different between the two groups(P＞0.05). Furthermore, there was no significant difference of the PI and AUC in the central areas between the two groups(P＞0.05). The AUC value of PI and AUC in the peripheral area in predicting lymph node metastasis was 0.733 and 0.708, respectively. PI showed a 67.6% sensitivity and 82.4%% specificity with the cutoff value of 8.04 dB, and those were 64.9% and 79.4 for AUC with a cutoff value of 202.99 dB s.
Conclusions The PI and AUC in the peripheral area of PTC nodule were significantly higher in the lymph node metastasis group than those in the non-metastasis group. Therefore, they may have considerable clinical value in the prediction of cervical lymph node metastasis of PTC. |
| Key words: Papillary thyroid carcinoma Lymph node metastasis CEUS Quantitative parameters Peripheral area |
