目的 比较分析64排螺旋CT与超 声造影在甲状腺乳头状癌(PTC)术前颈部 淋巴结转移中的诊断价值。方法 以本院 2015年1月-2017年6月经手术病理证实的 175例PTC患者为研究对象，术前均行64 排螺旋CT、超声造影检查，以病理结果为 金标准，比较不同检查手段对术前PTC及 颈部淋巴结转移的诊断符合率。结果 术 前CT检查对PTC、颈部淋巴结转移诊断符 合率与超声造影比较差异无统计学意义(P ＞0.05)。颈部淋巴结转移影像学特征方 面，术前CT检查、术后病理证实53例患者 有明显钙化26例；淋巴结有囊性变22例； 术前超声造影检查、术后病理证实转移者 造影模式、造影峰值强度、灌注区、边 界、灌注面积同灰阶面积相比、PI与非颈 部淋巴结转移者比较差异均有显著性差异 (P＜0.05)。结论 64排螺旋CT与超声造影 对PTC及其术前颈部淋巴结转移诊断均有 较大的价值。

Objective To comparatively analyze the value of 64 slice spiral CT and contrast-enhanced ultrasound in the preoperative diagnosis of cervical lymph node metastasis of papillary thyroid cancer (PTC). Methods 175 patients with PTC confirmed by operation and pathology in our hospital from January 2015 to June 2017 were enrolled in this study. All patients were examined with 64 slice spiral CT and contrastenhanced ultrasound before operation. The accordance rates of different examination methods for preoperative PTC and cervical lymph node metastasis were compared with the pathological results as the golden standard. Results There was no significant difference in the coincidence rates between preoperative CT examination and contrast-enhanced ultrasound in the diagnosis of PTC and cervical lymph node metastasis (P>0.05). In terms of imaging features of cervical lymph node metastasis, preoperative CT examination and postoperative pathology confirmed that 26 cases had obvious calcification in 53 cases, and 22 cases had cystic change in lymph nodes. Preoperative contrast-enhanced ultrasound and postoperative pathology confirmed that there were significant differences of contrast mode, peak intensity, perfusion area, border, the ratio of perfusion area and gray area and PI between patients with metastasis and patients without lymph node metastasis (P<0.05). Conclusion 64 slice spiral CT and contrast-enhanced ultrasound are of great value in the diagnosis of PTC and its preoperative cervical lymph node metastasis.