中国实用外科杂志

中国实用外科杂志

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甲状腺癌颈淋巴结转移影像学诊断方法选择及评价

陈    曦，陈海珍   

  1. 上海交通大学医学院附属瑞金医院外科，上海200025
  • 出版日期:2017-09-01 发布日期:2017-09-05

  • Online:2017-09-01 Published:2017-09-05

摘要：

绝大多数甲状腺癌易发生区域淋巴结转移，早期发现有利于制定合理手术方式，高频超声及增强CT是常规而有效的检查方法。淋巴结转移的超声征象包括体积增大、形态变圆、淋巴门结构消失、内见高回声团块、囊性变、钙化及有异常血管分布。CT检查发现肿大且密度不均、有融合趋势、强化不均匀的淋巴结亦提示恶性可能。超声定位下可疑淋巴结细针穿刺细胞学检查及穿刺洗脱液甲状腺球蛋白或降钙素测定都能帮助定性诊断甲状腺癌淋巴结转移。

关键词: 甲状腺癌, 颈淋巴结转移, 影像学

Abstract:

Diagnostic approach for detecting of cervical lymph node metastasis from thyroid cancer        CHEN Xi, CHEN Hai-zhen. Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025，China
Corresponding author: CHEN Xi, E-mail:cx10774@rjh.com.cn
Abstract    Thyroid cancer has a relatively high rate of lymph node metastasis. Ultrasound is the first imaging technique used for the assessment of cervical lymph node metastasis in patients with thyroid cancer. Enlarged axis, round shape, loss of an echogenic fatty hilum, cystic change, calcification, and abnormal vascularity are sonographic signs of metastatic lymph nodes. CT may be used as a complementary diagnostic method. Enlarged size, nodal grouping, calcification, cystic or necrotic change and abnormal enhancement suggest malignant possibility. Ultrasound guided fine needle aspiration cytology (FNAC) and thyroglobulin or calcitonin measurement in wash-out fluid of FNA has satisfactory diagnostic performance in lymph node metastasis.

Key words: thyroid cancer, cervical lymph node metastasis, imaging