Diagnosis value of contrast-enhanced ultrasound and SPECT/CT in postoperative cervical lymph node metastasis of differentiated thyroid cancer
YU Ting
WU Mei
Abstract：Objective To systematically evaluate the clinical value of contrast-enhanced ultrasound(CEUS)and single-photon emission computed tomography/computed tomography(SPECT/CT)in diagnosing cervical lymph node metastasis in postoperative patients with differentiated thyroid carcinoma(DTC).Methods The clinical data of 56 postoperative DTC patients from September 2021 to December 2023 were retrospectively analyzed.All patients underwent both CEUS and SPECT/CT examinations,and the pathological results of lymph node puncture served as the gold standard to compare the diagnostic efficacy of the two imaging methods.Results Among the 56 patients,pathology confirmed lymph node metastasis in 41 cases and no metastasis in 15 cases.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of CEUS were 75.6%,86.7%,93.9%,and 56.5%,respectively,while those of SPECT/CT were 48.8%,100%,100%,and 41.7%,respectively.The sensitivity of CEUS was significantly higher than that of SPECT/CT(P<0.05),whereas the difference in specificity was not statistically significant(P>0.05).CEUS image characteristic analysis revealed that most metastatic lymph nodes exhibited centripetal(80.5%,33/41)and heterogeneous(75.6%,31/41)enhancement patterns.Quantitavive analysis results showed that contrast agent clearance time in metastatic lymph nodes was significantly longer than that in benign lymph nodes[(195.61±49.27)s vs.(163.20±43.65)s,P<0.05].Lymph node region analysis indicated that metastatic lymph nodes were predominantly located in the lateral cervical region,with Level Ⅲ having the highest metastasis rate(92.9%).The typical SPECT/CT image presentation was focal iodine uptake increase,corresponding to the enhanced areas on CEUS.Conclusion CEUS demonstrates high sensitivity in diagnosing cervical lymph node metastasis after DTC surgery,making it suitable for early screening;SPECT/CT exhibits extremely high specificity,rendering it more conducive to confirmation.The combined application of both modalities can complement their advantages,improve diagnostic accuracy,and provide a reliable basis for formulating individualized clinical treatment plans.
Keywords：differentiated thyroid carcinomacontrast-enhanced ultrasoundSPECT/CT examinationcervical lymph node metastasisdiagnostic value
Publication Date：2025-11-28
Online Publishing Date：2026-01-05(First online date of this platform, not the publication date of the document)
Pages：5( 1128-1132 )