目的 探讨乳头状甲状腺癌(PTC)颈部转移淋巴结的超声表现特征,并评价超声联合SPECT/CT检查对甲状腺癌颈部转移淋巴结的诊断价值.方法 回顾性分析64例经病理证实的PTC颈部淋巴结转移的超声表现,与相应病理结果进行对比分析,其中18例先后接受超声和SPECT/CT检查.结果 超声探及53例淋巴结,正确诊断46例(46/64,71.88％),主要表现为淋巴门消失,短径≥5 mm,血供丰富,点状强回声聚集,部分液化或融合.18例联合检查中,超声正确诊断14例(14/18,77.78％),SPECT/CT正确诊断12例(12/18,66.67％),超声和SPECT/CT对于转移淋巴结的检出率无差别.结论 PTC颈部淋巴结转移具有特征性超声表现,SPECT/CT可发现超声较难检出的颈中央区及早期淋巴结转移.%Objective To explore the ultrasonic features of cervical lymph node metastasis in papillary thyroid carcinomas (PTC), and to observe the diagnostic value of US combining SPECT/CT. Methods The ultrasonic features of cervical lymph node metastasis in 64 patients with PTC confirmed pathologically were analyzed retrospectively. The results were compared with pathological finding. Among 64 patients, 18 underwent both US and SPECT/CT. Results The lymph node of 53 patients were discovered by US, 46 of them were positive (46/64, 71. 88%). Disappear of hilars of lymph nodes, short axis ≥5 mm, rich blood supply, point-like strong echoes and liquefaction or fusion were the main US features. In 18 patients underwent both US and SPECT/CT, 14 were correctly diagnosed with US (14/18, 77. 78%), 12 were correctly diagnosed with SPECT/CT (12/18, 66. 67%). No significant difference was found in the detective rate of PTC cervical lymph node metastasis between US and SPECT/CT. Conclusion The ultrasonic features of cervical lymph nodes metastasis from PTC are characteristic. SPECT/CT could sometimes discover the anterior cervical lymph nodes which are difficult for US.
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