摘要
目的评估多模态超声检查技术对预测甲状腺乳头状癌(PTC)术前发生中央区域淋巴结转移(CLNM)的准确度。方法选择经手术治疗的甲状腺结节患者108例,其中男性19例,女性89例;年龄20~77岁,平均年龄47.1岁;结节大小1.0~2.6 cm,平均结节大小1.9 cm。全部病例均经病理诊断为PTC,且术前均行多模态超声检测,包括常规二维超声、超声造影(CEUS)技术和微血流成像(MFI)检测技术。按照中央区域淋巴结有无转移,将患者分为非转移组与转移组,记录两组患者的病理特点和超声波特点,分析PTC患者中出现CLNM的独立风险因子。并且绘制受试者工作特性(ROC)曲线,评估其特异度、灵敏度和准确度,并对比了各种诊断模式来评估其准确度。结果经病理诊断,CLNM 43例(39.8%)。Logistic回归分析显示二维超声下结节与被膜接触、结节直径≥0.8 cm、MFI模式下中央型血流分布模式、在CEUS模式下的结节与被膜的接触及向心性灌注等因素是导致CLNM的独立风险因子(P<0.05);多模态超声在预测CLNM风险的准确度显著优于单一的检测模式,其灵敏度、特异度、准确度依次为76.7%、81.5%、80.2%,三者间差异有统计学意义(P<0.05)。结论MFI、CEUS和二维超声相结合应用可以更加准确地预测PTC手术前颈部淋巴结的转移情况。
Objective To evaluate the accuracy of multimodal ultrasound in predicting preoperative central lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods A total of 108 patients with thyroid nodules performed surgical treatment were enrolled,which included 19 males and 89 females,aged 20-77 years old with mean age of 47.1 years old;diameter of nodules was 1.0-2.6 cm with mean diameter of 1.9 cm.All of them were pathologically diagnosed as PTC,and preoperative multimodal ultrasound examination was performed,which included conventional two-dimensional ultrasound,contrast-enhanced ultrasound(CEUS)and micro-flow imaging(MFI).According to CLNM,all of them were divided into non-metastasis group and metastasis group.The pathological characteristics and ultrasonic characteristics of 2 groups were recorded,and independent risk factors of CLNM in PTC patients were analyzed.The receiver operating characteristic(ROC)curve was drawn to evaluate the specificity,sensitivity and accuracy of multimodal ultrasound,and various diagnostic models were applied and compared to evaluate its accuracy.Results The CLNM was pathologically diagnosed in 43 cases(39.8%).Logistic regression analysis showed that the independent risk factors for CLNM were contact between nodules and capsule by two-dimensional ultrasound,nodule diameter≥0.8 cm,central blood flow distribution mode by MFI,contact between nodules and capsule by CEUS and centripetal perfusion(P<0.05).The accuracy of multimodal ultrasound in predicting CLNM risk was significantly better than that of single detection mode.The sensitivity,specificity and accuracy of multimodal ultrasound were 76.7%,81.5%and 80.2%,respectively,and the difference was statistically significant than other 3 modes(P<0.05).Conclusion It is demonstrated that the combination of MFI,CEUS,and two-dimensional ultrasound could more accurately predict the preoperative cervical lymph node metastasis of PTC.
作者
李晓青
刘昕
徐艺泽
王若雪
郑冬
马策
安云恒
LI Xiao-qing;LIU Xin;XU Yi-ze;WANG Ruo-xue;ZHENG Dong;MA Ce;AN Yun-heng(Baoding No.1 Central Hospital,Baoding071000,Hebei,China)
出处
《生物医学工程与临床》
CAS
2024年第5期689-695,共7页
Biomedical Engineering and Clinical Medicine
基金
保定市科技计划项目(2341ZF239)。
关键词
甲状腺乳头状癌
中央区域淋巴结转移
微血流成像
超声造影
多模态超声
papillary thyroid carcinoma
central lymph node metastasis
micro-flow imaging
contrast-enhanced ultrasound
multimodal ultrasound
