弹性成像在筛查甲状腺乳头状癌颈淋巴结转移中的研究进展
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摘要
甲状腺乳头状癌(PTC)常伴有颈部淋巴结转移。判断淋巴结是否存在转移对甲状腺乳头癌患者选择清扫范围至关重要。临床上,弹性成像已被证实是一种有效的筛查恶性肿瘤手段。初步资料显示,其可能有效地筛查出颈部组织的恶性肿瘤,特别是颈部淋巴结的转移。但目前弹性成像的诊断标准和成像技术存在很大差异,这些研究中包括的转移淋巴结的原发灶各不相同。今后需要在特定的肿瘤患者人群中建立可重复的临床标准。由于PTC具有颈部淋巴结转移和复发的倾向,故PTC可作为研究弹性成像在颈部淋巴结中临床应用的特定人群。
Papillary thyroid carcinoma( PTC) is often accompanied by cervical lymph node metastasis,the detection of which is important in planning selective lymph node dissection. Elastography has been proved to be an effective method for screening malignant tumors in clinical. Preliminary data suggest that it may be effective in screening cervical malignant tumors,especially cervical lymph node metastasis. However,the diagnostic criteria and imaging techniques for elastography vary widely,and the primary tumors of the metastatic lymph nodes included in these studies are different. Repeatable clinical criteria in specific tumor patient populations should be established in the future. PTC patients can be used as a specific population to study the clinical application of elastography in the cervical lymph nodes because of its tendency of cervical lymph node metastasis and recurrence.
Papillary thyroid carcinoma( PTC) is often accompanied by cervical lymph node metastasis,the detection of which is important in planning selective lymph node dissection. Elastography has been proved to be an effective method for screening malignant tumors in clinical. Preliminary data suggest that it may be effective in screening cervical malignant tumors,especially cervical lymph node metastasis. However,the diagnostic criteria and imaging techniques for elastography vary widely,and the primary tumors of the metastatic lymph nodes included in these studies are different. Repeatable clinical criteria in specific tumor patient populations should be established in the future. PTC patients can be used as a specific population to study the clinical application of elastography in the cervical lymph nodes because of its tendency of cervical lymph node metastasis and recurrence.
引文
[1]丁珂,严昆.超声对预测甲状腺乳头状癌颈部淋巴结转移的研究进展[J].中国临床医学影像杂志,2016,27(9):663-666.
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[3]Rosário PW,de Faria S,Bicalho L,et al.Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma[J].J Ultrasound Med,2005,24(10):1385-1389.
[4]Coquia SF,Chu LC,Hamper UM.The role of sonography in thyroid cancer[J].Radiol Clin North Am,2014,52(6):1283-1294.
[5]Joo JY,Jin J,Seo ST,et al.Recurrence in regional lymph nodes after total thyroidectomy and neck dissection in patients with papillary thyroid cancer[J].Oral Oncol,2015,51(2):164-169.
[6]Hay ID,Thompson GB,Grant CS,et al.Papillary thyroid carcinoma managed at the Mayo Clinic during six decades(1940-1999):Temporal trends in initial therapy and long-term outcome in 2444consecutively treated patients[J].World J Surg,2002,26(8):879-885.
[7]Saadi R,LaRusso S,Vijay K,et al.Elastography as a potential modality for screening cervical lymph nodes in patients with papillary thyroid cancer:A review of literature[J].Ear Nose Throat J,2018,97(1/2):31-39.
[8]Dobruch-Sobczak K,Zalewska EB,Gumińska A,et al.Diagnostic Performance of Shear Wave Elastography Parameters Alone and in Combination with Conventional B-Mode Ultrasound Parameters for the Characterization of Thyroid Nodules:A Prospective,Dual-Center Study[J].Ultrasound Med Biol,2016,42(12):2803-2811.
[9]Kim HJ,Choi IH,Jin SY,et al.Efficacy of Shear-Wave Elastography for Detecting Postoperative Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma[J].Int J Endocrinol,2018,2018:9382649.
[10]Liu Z,Zeng W,Liu C,et al.Diagnostic accuracy of ultrasonographic features for lymph node metastasis in papillary thyroid microcarcinoma:A single-center retrospective study[J].World JSurg Oncol,2017,15(1):32.
[11]Kabaker AS,Tublin ME,Nikiforov YE,et al.Suspicious ultrasound characteristics predict BRAF V600E-positive papillary thyroid carcinoma[J].Thyroid,2012,22(6):585-589.
[12]Kim SJ,Lee KE,Myong JP,et al.BRAF V600E mutation is associated with tumor aggressiveness in papillary thyroid cancer[J].World J Surg,2012,36(2):310-317.
[13]Ricarte-Filho J,Ganly I,Rivera M,et al.Papillary thyroid carcinomas with cervical lymph node metastases can be stratified into clinically relevant prognostic categories using oncogenic BRAF,the number of nodal metastases,and extra-nodal extension[J].Thyroid,2012,22(6):575-584.
[14]Lenghel LM,Bolboaca SD,Botar-Jid C,et al.The value of a new score for sonoelastographic differentiation between benign and malignant cervical lymph nodes[J].Med Ultrason,2012,14(4):271-277.
[15]Stulak JM,Grant CS,Farley DR,et al.Value of preoperative ultrasonography in the surgical management of initial and reoperative papillary thyroid cancer[J].Arch Surg,2006,141(5):489-494.
[16]Ophir J,Céspedes I,Ponnekanti H,et al.Elastography:A quantitative method for imaging the elasticity of biological tissues[J].Ultrason Imaging,1991,13(2):111-134.
[17]Yang L,Yuan J,Wang Q,et al.Reliability analysis of acoustic radiation force impulse ultrasound imaging with virtual touch tissue quantification:Ex vivo ox liver[J].Ultrasound Q,2015,31(1):59-62.
[18]Park AY,Kim JA,Son EJ,et al.Shear-Wave Elastography for Papillary Thyroid Carcinoma can Improve Prediction of Cervical Lymph Node Metastasis[J].Ann Surg Oncol,2016,23(Suppl 5):722-729.
[19]Gallotti A,D'Onofrio M,Pozzi Mucelli R.Acoustic Radiation Force Impulse(ARFI)technique in ultrasound with Virtual Touch tissue quantification of the upper abdomen[J].Radiol Med,2010,115(6):889-897.
[20]Lyshchik A,Higashi T,Asato R,et al.Cervical lymph node metastases:Diagnosis at sonoelastography-initial experience[J].Radiology,2007,243(1):258-267.
[21]丁杰,李国杰,朱向明.实时超声弹性成像在颈部淋巴结疾病诊断中的价值[J].吉林医学,2014,35(7):1388-1389.
[22]Alam F,Naito K,Horiguchi J,et al.Accuracy of sonographic elastography in the differential diagnosis of enlarged cervical lymph nodes:Comparison with conventional B-mode sonography[J].AJR Am J Roentgenol,2008,191(2):604-610.
[23]李斌,李德来,杨金耀,等.超声弹性成像技术研究现状[J].北京生物医学工程,2017,36(5):535-539.
[24]刘丽娟,徐晓红,杨永光,等.声脉冲辐射力弹性成像在颈部淋巴结良恶性诊断中的价值[J].分子影像学杂志,2015,38(4):332-334.
[25]高晓丽,周丽莉,张桂萍,等.声触诊组织成像与定量(VTIQ)和声触诊组织定量(VTQ)在诊断甲状腺TI-RADS4级结节中的对比研究[J].新疆医科大学学报,2018,41(4):452-456.
[26]王尚,陈文卫.超声诊断颈部转移性淋巴结的应用进展[J].临床超声医学杂志,2018,20(10):698-700.
[27]Gennisson JL,Deffieux T,Fink M,et al.Ultrasound elastography:Principles and techniques[J].Diagn Interv Imaging,2013,94(5):487-495.
[28]黄妮,朱才义.超声成像新技术在乳腺癌诊疗中的应用进展[J].临床超声医学杂志,2018,20(6):405-408.
[29]Bhatia KS,Cho CC,Tong CS,et al.Shear wave elasticity imaging of cervical lymph nodes[J].Ultrasound Med Biol,2012,38(2):195-201.
[30]You J,Chen J,Xiang F,et al.The value of quantitative shear wave elastography in differentiating the cervical lymph nodes in patients with thyroid nodules[J].J Med Ultrason,2018,45(2):251-259.
[31]Hang J,Li F,Qiao XH,et al.Combination of Maximum Shear Wave Elasticity Modulus and TIRADS Improves the Diagnostic Specificity in Characterizing Thyroid Nodules:A Retrospective Study[J].Int J Endocrinol,2018,2018:4923050.
[2]Sohn YM,Kwak JY,Kim EK,et al.Diagnostic approach for evaluation of lymph node metastasis from thyroid cancer using ultrasound and fine-needle aspiration biopsy[J].AJR Am J Roentgenol,2010,194(1):38-43.
[3]Rosário PW,de Faria S,Bicalho L,et al.Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma[J].J Ultrasound Med,2005,24(10):1385-1389.
[4]Coquia SF,Chu LC,Hamper UM.The role of sonography in thyroid cancer[J].Radiol Clin North Am,2014,52(6):1283-1294.
[5]Joo JY,Jin J,Seo ST,et al.Recurrence in regional lymph nodes after total thyroidectomy and neck dissection in patients with papillary thyroid cancer[J].Oral Oncol,2015,51(2):164-169.
[6]Hay ID,Thompson GB,Grant CS,et al.Papillary thyroid carcinoma managed at the Mayo Clinic during six decades(1940-1999):Temporal trends in initial therapy and long-term outcome in 2444consecutively treated patients[J].World J Surg,2002,26(8):879-885.
[7]Saadi R,LaRusso S,Vijay K,et al.Elastography as a potential modality for screening cervical lymph nodes in patients with papillary thyroid cancer:A review of literature[J].Ear Nose Throat J,2018,97(1/2):31-39.
[8]Dobruch-Sobczak K,Zalewska EB,Gumińska A,et al.Diagnostic Performance of Shear Wave Elastography Parameters Alone and in Combination with Conventional B-Mode Ultrasound Parameters for the Characterization of Thyroid Nodules:A Prospective,Dual-Center Study[J].Ultrasound Med Biol,2016,42(12):2803-2811.
[9]Kim HJ,Choi IH,Jin SY,et al.Efficacy of Shear-Wave Elastography for Detecting Postoperative Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma[J].Int J Endocrinol,2018,2018:9382649.
[10]Liu Z,Zeng W,Liu C,et al.Diagnostic accuracy of ultrasonographic features for lymph node metastasis in papillary thyroid microcarcinoma:A single-center retrospective study[J].World JSurg Oncol,2017,15(1):32.
[11]Kabaker AS,Tublin ME,Nikiforov YE,et al.Suspicious ultrasound characteristics predict BRAF V600E-positive papillary thyroid carcinoma[J].Thyroid,2012,22(6):585-589.
[12]Kim SJ,Lee KE,Myong JP,et al.BRAF V600E mutation is associated with tumor aggressiveness in papillary thyroid cancer[J].World J Surg,2012,36(2):310-317.
[13]Ricarte-Filho J,Ganly I,Rivera M,et al.Papillary thyroid carcinomas with cervical lymph node metastases can be stratified into clinically relevant prognostic categories using oncogenic BRAF,the number of nodal metastases,and extra-nodal extension[J].Thyroid,2012,22(6):575-584.
[14]Lenghel LM,Bolboaca SD,Botar-Jid C,et al.The value of a new score for sonoelastographic differentiation between benign and malignant cervical lymph nodes[J].Med Ultrason,2012,14(4):271-277.
[15]Stulak JM,Grant CS,Farley DR,et al.Value of preoperative ultrasonography in the surgical management of initial and reoperative papillary thyroid cancer[J].Arch Surg,2006,141(5):489-494.
[16]Ophir J,Céspedes I,Ponnekanti H,et al.Elastography:A quantitative method for imaging the elasticity of biological tissues[J].Ultrason Imaging,1991,13(2):111-134.
[17]Yang L,Yuan J,Wang Q,et al.Reliability analysis of acoustic radiation force impulse ultrasound imaging with virtual touch tissue quantification:Ex vivo ox liver[J].Ultrasound Q,2015,31(1):59-62.
[18]Park AY,Kim JA,Son EJ,et al.Shear-Wave Elastography for Papillary Thyroid Carcinoma can Improve Prediction of Cervical Lymph Node Metastasis[J].Ann Surg Oncol,2016,23(Suppl 5):722-729.
[19]Gallotti A,D'Onofrio M,Pozzi Mucelli R.Acoustic Radiation Force Impulse(ARFI)technique in ultrasound with Virtual Touch tissue quantification of the upper abdomen[J].Radiol Med,2010,115(6):889-897.
[20]Lyshchik A,Higashi T,Asato R,et al.Cervical lymph node metastases:Diagnosis at sonoelastography-initial experience[J].Radiology,2007,243(1):258-267.
[21]丁杰,李国杰,朱向明.实时超声弹性成像在颈部淋巴结疾病诊断中的价值[J].吉林医学,2014,35(7):1388-1389.
[22]Alam F,Naito K,Horiguchi J,et al.Accuracy of sonographic elastography in the differential diagnosis of enlarged cervical lymph nodes:Comparison with conventional B-mode sonography[J].AJR Am J Roentgenol,2008,191(2):604-610.
[23]李斌,李德来,杨金耀,等.超声弹性成像技术研究现状[J].北京生物医学工程,2017,36(5):535-539.
[24]刘丽娟,徐晓红,杨永光,等.声脉冲辐射力弹性成像在颈部淋巴结良恶性诊断中的价值[J].分子影像学杂志,2015,38(4):332-334.
[25]高晓丽,周丽莉,张桂萍,等.声触诊组织成像与定量(VTIQ)和声触诊组织定量(VTQ)在诊断甲状腺TI-RADS4级结节中的对比研究[J].新疆医科大学学报,2018,41(4):452-456.
[26]王尚,陈文卫.超声诊断颈部转移性淋巴结的应用进展[J].临床超声医学杂志,2018,20(10):698-700.
[27]Gennisson JL,Deffieux T,Fink M,et al.Ultrasound elastography:Principles and techniques[J].Diagn Interv Imaging,2013,94(5):487-495.
[28]黄妮,朱才义.超声成像新技术在乳腺癌诊疗中的应用进展[J].临床超声医学杂志,2018,20(6):405-408.
[29]Bhatia KS,Cho CC,Tong CS,et al.Shear wave elasticity imaging of cervical lymph nodes[J].Ultrasound Med Biol,2012,38(2):195-201.
[30]You J,Chen J,Xiang F,et al.The value of quantitative shear wave elastography in differentiating the cervical lymph nodes in patients with thyroid nodules[J].J Med Ultrason,2018,45(2):251-259.
[31]Hang J,Li F,Qiao XH,et al.Combination of Maximum Shear Wave Elasticity Modulus and TIRADS Improves the Diagnostic Specificity in Characterizing Thyroid Nodules:A Retrospective Study[J].Int J Endocrinol,2018,2018:4923050.