The diagnostic value of ultrasound combined with CT in lymph node metastasis of thyroid cancer

YANG Qianlong; GENG Baocheng; LI Ji

doi:10.20258/j.cnki.1006-9011.2025.08.009

Abstract：Objective To explore the diagnostic value of lymphatic contrast-enhanced ultrasound combined with CT dual en-ergy imaging for cervical lymph node metastasis in papillary thyroid carcinoma(PTC).Methods Forty six PTC patients admit-ted to our hospital were selected and underwent lymphatic contrast-enhanced ultrasound combined with CT dual energy imaging.The postoperative lymph node pathological section examination was used as the gold standard to determine whether the patients had cervical lymph node metastasis,and they were divided into a metastasis group and a non-metastasis group.Then,we com-pared the characteristics of lymphatic ultrasound contrast and CT dual energy imaging between two groups and their diagnostic value for PTC cervical lymph node metastasis.Results Among 46 PTC patients,30 cases had cervical lymph node metastasis,while,16 cases did not have cervical lymph node metastasis.The proportion of patients with irregular morphology,high echo-genicity of lymph node medulla,uneven thickening of lymph node cortex,uneven echogenicity,narrowing,eccentricity or disap-pearance of lymph node hilum,mixed blood flow,no enhancement of lymph nodes,and uneven enhancement in the metastatic group were significantly higher than those in the non-metastatic group(P<0.05).The proportion of patients with a maximum short diameter greater than 10 mm,irregular morphology,internal calcification,heterogeneous tissue density,significant arterial phase enhancement,and uneven enhancement in the metastatic group were higher than those in the non-metastatic group,and the differences were statistically significant(P<0.05).The positive predictive values of lymphatic ultrasound contrast,CT dual energy imaging,and combined diagnosis of cervical lymph node metastasis in PTC patients were 92.59%(25/27),93.10%(27/29),and 93.55%(29/31),respectively.The negative predictive values were 73.68%(14/19),88.24%(15/17),and 93.33%(14/15),respectively.The diagnostic accuracies were 84.78%(39/46),91.30%(42/46),and 93.48%(43/46),respectively,with consistent Kappa values of 0.679,0.811,and 0.691,respectively.The NIC and λHU in the arterial phase of the metastatic group were higher than those in the non-metastatic group(P<0.05).The sensitivity and specificity of single and combined diagno-sis of cervical lymph node metastasis in PTC patients using NIC and λHU were 78.39%,79.04%,and 91.25%,respectively,and 80.37%,77.16%,and 75.43%,respectively.Conclusion The accuracy of lymphatic ultrasound contrast combined with CT dual energy imaging in diagnosing cervical lymph node metastasis in PTC patients is relatively high.