Abstract:
Objective To investigate the ultrasonographic features of cervical lymph node metastasis after differentiated thyroid cancer (DTC), evaluate the diagnostic features of ultrasonography, and improve the diagnostic rate.
Methods A total of 123 patients with DTC were enrolled in this study. Forty cases of cervical lymph node metastasis confirmed by fine needle aspiration cytology or surgical pathology(observation group), 83 cases without metastasis(control group), compared between the two groups. Ultrasound sonographic features of cervical lymph nodes before treatment: long-term/short-diameter ratio of lymph nodes, microcalcification, presence of lymphatic portal structures, color Doppler flow imaging, cystic or liquefaction changes. The comparison between the group count data was analyzed by χ
2, and the sensitivity, specificity, accuracy, specificity, positive and negative predictive value of the ultrasound diagnosis were analyzed.
Results In the observation group, the ratio of length to diameter of 33 lymph nodes was <2, and 9 cases in the control group.In the observation group, 17 cases were microcalcification, 2 cases in the control group, and 7 cases in the lymphatic observation group were unclear. Two cases showed unclear; 12 cases in the color flow observation group showed abundant blood flow, and 3 cases in the control group. There were 4 cases in the cystic or liquefied area observation group and 1 case in the control group. The positive proportions of the five sonograms were 82.5%, 42.5%, 17.5%, 30.0%, and 10.0%, respectively. The long-term/short-diameter <2 in the cervical lymph node metastasis was significantly higher than that in the cervical lymph nodes. The patients with metastasis were statistically significant(
P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of cervical lymph node metastasis after DTC were 82.5%, 74.7%, 77.2%, 61.1% and 89.9%.
Conclusion Ultrasonography has high sensitivity and specificity for the diagnosis of cervical lymph node metastasis after DTC.It can diagnose cervical lymph node metastasis through various characteristic ultrasound findings.