超声和CT对术前甲状腺乳突状癌颈部转移淋巴结的评价

摘要

目的：评估超声和CT对术前甲状腺乳突状癌颈部转移淋巴结治疗方案的作用。方法收集我院2008-01～2013-12间收治的252例甲状腺乳突状癌颈部转移淋巴结临床病例和影像资料，以上患者均行甲状腺切除术和颈淋巴结清扫。结果超声和CT探测中央区转移淋巴结敏感性（23％，41％）低于外侧区转移淋巴结敏感性（70％，82％）。超声和CT检出中央区转移淋巴结特异性为97％、90％，外侧区转移淋巴结特异性为84％、64％。根据超声和CT检查结果59％病人行外侧区颈部淋巴结清扫，32.1％病人行中央区颈淋巴结清扫。结论超声和CT对术前评估甲状腺乳突状癌中央区转移淋巴结清扫尚有一定局限性，检出敏感性较低，但有助于探测到未触及转移淋巴结。%Objective To evaluate the impact of preoperative ultrasonography ( US) and computed tomography ( CT) on the preopera-tive of cervical lymph node metastases in papillary thyroid carcinoma ( PTC).Methods Medical records and imaging findings were retro-spectively analyzed for 252 patients with PTC who underwent thyroidectomy with neck dissection between January , 2008 and December , 2013.Results The sensitivity of both imaging techniques was lower in the central neck ( 23%, 41%) than in the lateral neck ( 70%, 82%).The specificities of US and CT were 97%and 90%in the central neck , and 84%and 64%in the lateral neck.The surgical plans for therapeutic neck dissection were based on imaging findings in 59% patients who underwent lateral compartment neck dissection and in 32.1%patients who underwent central compartment neck dissection.Conclusion The roles of preoperative US and CT in surgical planning for central compartment neck dissection in PTC are limited because of their low sensitivity in the central neck , but US and CT may be useful in cases with non-palpable lateral neck nodes.