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[1]熊爱民,彭民,钱嵘,等.彩色多普勒超声诊断乳头状甲状腺癌术后复发的临床价值[J].医学研究与战创伤救治(原医学研究生学报),2014,16(04):373-375.[doi:10.3969/j.issn.1672-271X.2014.04.012]
　XIONG Ai-min,PENG Min,QIAN Rong,et al.The value of color Doppler ultrasound in the diagnosis of papillary thyroid carcinoma recurrence in postoperation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(04):373-375.[doi:10.3969/j.issn.1672-271X.2014.04.012]
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彩色多普勒超声诊断乳头状甲状腺癌术后复发的临床价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第16卷
期数:
2014年04期
页码:
373-375
栏目:
出版日期:
2014-07-31

文章信息/Info

Title:
The value of color Doppler ultrasound in the diagnosis of papillary thyroid carcinoma recurrence in postoperation
作者:
熊爱民1; 彭民2; 钱嵘1; 徐振1; 薛菲2
1.200052 上海，解放军85医院特诊科；2.200052 上海，解放军455医院
Author(s):
XIONG Ai-min1; PENG Min2; QIAN Rong1; XU Zhen1; XUE Fei2.
1.Department of Ultrasound，85 Hospital of PLA，Shanghai 200052，China；2.455 Hospital of PLA，Shanghai 200052，China
关键词:
乳头状甲状腺癌; 复发; 超声检查
Keywords:
papillary thyroid carcinoma;  recurrence;  ultrasongraphy
分类号:
R445.1;R736.1
DOI:
10.3969/j.issn.1672-271X.2014.04.012
文献标志码:
A
摘要:
目的 分析乳头状甲状腺癌术后复发的超声声像图特征及其复发特点，评价彩超对其的诊断价值。方法 回顾分析经手术及病理证实的45例乳头状甲状腺癌的术后复发时间、复发部位及复发癌超声声像图特征。结果 乳头状甲状腺癌术后复发时间:4个月～1年9例，1～2年16例，2～3年11例，>3年9例。复发部位及声像图特征:颈部淋巴结转移39例(86.7%)，转移淋巴结表现为圆形或不规则形，L/T＜2，皮质增厚，髓质变形或缺失，无淋巴门，见囊性变或微钙化、高回声，血流分布为无或周围型及混合型；患侧甲状腺床复发3例(6.7%)，复发癌呈低回声，边界不清，常侵犯周围组织；对侧甲状腺复发2例(4.4%)，复发癌呈低回声，形态不规则，A/T≥1，见微钙化；肺及纵隔淋巴结转移1例(2.2%)。结论 乳头状甲状腺癌术后复发时间以术后6个月～3年多见(占80%)，复发部位以颈部淋巴结转移最多见(占86.7%)。超声对术后复发癌定性、定位诊断准确率高，结合超声引导下细针穿刺细胞学活检(US-FNA)，准确率可达95%以上，是诊断乳头状甲状腺癌术后复发的首选方法，建议术后超声定期随诊至少3年。
Abstract:
Objective To analyze the ultrasonic image and characteristics of papillary thyroid carcinoma in postoperative recurrence,evaluate the diagnostic value.Methods The recurrent time,recurrent location and ultrasonic image of 45 cases with papillary thyroid carcinoma confirmed by surgery and pathology were retrospectively analyzed.Results The recurrent time after operation was:less than 1 year in 9 cases,1 to 2 years in 16 cases,2 to 3 years in 11 cases,more than 3 years in 9 cases.The recurrent location and ultrasonic image was:neck lymph node metastasis in 39 cases (86.7%),metastasis lymph node showed round or irregular in shape and size,longitudinal/transverse ratio less than 2,cortical thickening,deformation or loss of part of the medulla,without hilus,with cystic degeneration or microcalfications,hyperechogenicity,blood flow distribution for no or peripheral type and mixed type.3 cases in the thyroid resected bed (6.7%).The recurrent tumor showed hypoechoic nodules,indefinite border,often invaded surrounding tissue.2 cases located in the contralateral thyroid(4.4%),the recurrent tumor showed hypoechoic nodules,irregular shape,anteroposterior/transverse ratio more than or equal to 1,with microcalfications.The lungs and mediastinal lymph node metastasis occurred in 1 case (2.2%).Conclusion The most of papillary thyroid cancer recurrence occurred in 6 months to 3 years after operation (80%),recurrent location often occurred in cervical lymph node metastasis (86.7%).Ultrasongraphy has high accuracy in diagnosis of recurrent thyroid cancinoma’s localization and qualitation,in combination with ultrasound guided fine needle aspiration cytology (US-FNA),accurate rate is above 95%.Ultrasongraphy is the first choice for diagnosis of recurrent papillary thyroid carcinoma,suggests that postoperative echocardiography regular follow-up for at least 3 years.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2014-07-20