Diagnostic value of ultrasonography combined with CT in evaluating cervical lymph node metastasis occurring in papil-lary thyroid cancer

LIU Haolei; LIU Chao; YANG Lizhou; CHEN Deqiang; KOU Jieli

doi:10.20258/j.cnki.1006-9011.2025.02.006

Abstract：Objective To explore the diagnostic role of ultrasound combined with CT in evaluating cervical lymph node me-tastasis in papillary thyroid carcinoma,and to analyze the advantages of their combined application.Methods A retrospective analysis was conducted on 113 patients with papillary thyroid carcinoma in our hospital.According to the occurrence of cervical lymph node metastasis,they were divided into a metastatic group of 54 cases and a non-metastatic group of 59 cases.Then,we compared the differences in ultrasound and CT features between two groups,and analyzed the value of ultrasound,CT,and the combined application in evaluating cervical lymph node metastasis in papillary thyroid carcinoma.Results Compared to the non-metastatic group,the metastatic group had higher internal microcalcifications,edge defects,lymph node shape≥2mm,as-pect ratio<2 mm,uneven portal echo,and higher uniformity of echo characteristics(P<0.05).Compared to the non-metastatic group,the metastatic group had higher rates of granular calcification,cystic necrosis of lymph nodes,enhanced lymph node mar-gins,unclear lymph node and surrounding tissue boundaries,irregular lymph node morphology,and lymph node length≥5mm(P<0.05).In evaluating the occurrence of cervical lymph node metastasis in papillary thyroid carcinoma,the sensitivity of ultra-sound and CT examination were 87.0%and 77.8%,respectively,and the specificity was 88.1%and 93.2%,respectively.The sensitivity and specificity of the joint evaluation were 98.1%and 88.1%,respectively.Compared with pathological examination,the Kappa values of ultrasound examination,CT examination,and combined evaluation of cervical lymph node metastasis in pap-illary thyroid carcinoma were 0.752,0.733,and 0.859,respectively.The missed detection rate of combined application was sig-nificantly lower than that of ultrasound and CT examinations(P<0.05).Conclusion Ultrasound examination and CT examina-tion have certain value in evaluating the occurrence of cervical lymph node metastasis in papillary thyroid carcinoma,and the combined application has better accuracy in evaluation.