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目的 探讨影像检查对甲状腺癌术中颈淋巴结清扫的指导作用。方法 将 60例甲状腺癌患者术前影像检查与手术所见、及术后病理检查作系统性对照分析。结果 对 60例患者的甲状腺癌术前进行彩色多普勒超声检查 ,其检出率为 81%。术前ECT检查中 42例 (70 % )显示甲状腺病灶放射物大量浓聚。 10例患者 99m Tc MIBI显像在甲状腺以外颈部发现异常浓聚斑点。 17例行颈淋巴结清扫患者中 ,15例术前由B超检查发现 ,10例ECT术前检查明确。 2例在术中探查颈静脉周围时发现有肿大淋巴结。结论 甲状腺癌根治手术的大小方式以及是否行颈淋巴结的清扫在很大程度上取决于术前影像检查和术中冰冻病理结果 ,影像检查对术中颈淋巴结的清扫具有很大的指导意义。
Objective To explore the role of imaging in the diagnosis of cervical lymph node dissection in thyroid cancer. Methods 60 cases of thyroid cancer patients with preoperative imaging and surgical findings, and postoperative pathological examination for systematic control analysis. Results Color Doppler echocardiography was performed preoperatively on 60 patients with thyroid cancer. The detection rate was 81%. Forty-two (70%) of the patients underwent preoperative ECT showed a strong accumulation of radioactive thyroid lesions. 99m Tc MIBI imaging in 10 patients found abnormally concentrated spots in the neck outside the thyroid. Of the 17 patients with cervical lymph node dissection, 15 were preoperatively confirmed by B-mode ultrasound and 10 were preoperatively examined by ECT. Two cases found swollen lymph nodes around the jugular vein during the operation. Conclusions The size of the radical operation of thyroid carcinoma and whether or not to clean the cervical lymph nodes depend largely on the preoperative imaging and intraoperative frozen pathological findings. Image examination is of great instructive significance for the dissection of cervical lymph nodes.