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《高頻超聲對(duì)甲狀腺癌頸部淋巴結(jié)轉(zhuǎn)移的鑒別診斷價(jià)值.pdf》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫。
1、中華現(xiàn)代影像學(xué)雜志JournalofChineseModernImaging2009年第6卷第2期·81··論著·高頻超聲對(duì)甲狀腺癌頸部淋巴結(jié)轉(zhuǎn)移的鑒別診斷價(jià)值顧斌[摘要]目的探討高頻超聲對(duì)鑒別甲狀腺癌患者頸部腫大淋巴結(jié)轉(zhuǎn)移的鑒別診斷價(jià)值。方法對(duì)甲狀腺癌患者的頸部淋巴結(jié)進(jìn)行評(píng)估,用高頻超聲診斷并測量淋巴結(jié),記錄形態(tài)、回聲、大小、部位,結(jié)果由病理證實(shí)。結(jié)果81例甲狀腺癌患者中49例出現(xiàn)頸部淋巴結(jié)轉(zhuǎn)移,絕大多數(shù)轉(zhuǎn)移淋巴結(jié)為圓形,無淋巴門的低回聲結(jié)節(jié)。淋巴結(jié)的形態(tài)對(duì)提示轉(zhuǎn)移最可靠,圓形、縱橫徑比小于2的低回聲淋巴結(jié)常提示轉(zhuǎn)移。在轉(zhuǎn)移性病灶中無淋巴門,內(nèi)部有囊變或鈣化明顯較良性多見。轉(zhuǎn)移性淋巴結(jié)更多位
2、于下頸1/3處。結(jié)論高頻超聲對(duì)甲狀腺癌患者頸部腫大淋巴結(jié)轉(zhuǎn)移有很高的診斷準(zhǔn)確率,能為臨床診斷、治療提供參考。[關(guān)鍵詞]淋巴結(jié);超聲檢查;甲狀腺癌[中圖分類號(hào)]R736.1[文獻(xiàn)標(biāo)識(shí)碼]A[文章編號(hào)]1681-2824(2009)02-0081-03Valueofhighfrequencyultrasonographicdifferentiationofbenignfrommalig2nantnecklymphadenopathyinthyroidcarcinomaGUBin.DepartmentofUltrasonography,TheYixingPeople?sHospital,Yixing
3、214200,China[Abstract]ObjectiveTostudyvalueofhighfrequencyultrasonographicdifferentiationofbenignfrommalig2nantnecklymphadenopathyinthyroidcarcinoma.MethodsWeevaluatednecklymphnodesinagroupofpatientswiththyroidcarcinoma.Nodesweredetectedandmeasuredbyhighfrequencyultrasonography,andtheirshape,echogen
4、icity,size,andlocationwerenoted.Outcomesweredeterminedfrompathologyreports.ResultsAmong81patientswiththyroidcarcinoma,49patientshadmetastaticnecknodes.Inmostcases,metastaseshadaroundshape,withahypoechoicnodeswithoutahilum,theshapeofthenodesseemedtobethemostreliableinsuggestingmalignancy.Aroundshapew
5、ithalongitudinal/transverseratiooflessthan2ofhypoechoicnodesindicatedthepresenceofmetastases.Theabsenceofanechogenichilumandthepresenceofcysticportionsandcalcificationsweresignificantlygreaterinmalignanciesthaninbenignlesions.Inmostcases,metastaticnodulesweresituatedintheloweronethirdoftheneck.Concl
6、usionHighfrequencyultrasonographycanprovidevaluablediagnosticinfor2mationwithahighdegreeofdiagnosticaccuratefornecklymphadenopathyinthyroidcarcinoma,andhelpsdiagno2sisandcure.[Keywords]lymphnodes;ultrasonography;thyroidcarcinoma甲狀腺癌,特別是乳頭狀腺癌,常有頸部淋巴結(jié)1資料與方法轉(zhuǎn)移。據(jù)文獻(xiàn)報(bào)道,甲狀腺乳頭狀腺癌的頸部淋巴111一般資料2002年1月～2006年12月
7、我院[1]結(jié)轉(zhuǎn)移率可高達(dá)50%～70%。目前,對(duì)于已發(fā)生手術(shù)治療甲狀腺癌患者81例,均在術(shù)前行超聲檢頸部淋巴轉(zhuǎn)移的甲狀腺癌患者,多數(shù)學(xué)者主張應(yīng)積查,術(shù)后經(jīng)病理證實(shí)。其中年齡最大75歲,最小17[2]極處理頸部轉(zhuǎn)移淋巴結(jié),以改善患者的預(yù)后。本歲,平均55.4歲。研究回顧性分析了81例甲狀腺癌患者頸部淋巴結(jié)112儀器與方法使用百勝DU26,PhilipsHD211高頻超聲檢查結(jié)果,將超聲征象與手術(shù)結(jié)果
