Objective To explore the value of clinical and dual energy CT(DECT)features for predicting lateral cervi-cal lymph node metastasis(LLNM)in papillary thyroid carcinoma(PTC).Methods Clinical and imaging data of 263 patients with pathologically proven PTC were retrospectively analyzed.Clinical and CT features including age,sex,thyroid function indicators,location,size,calcification,and cystic change were collected.Quantitative DECT parameters including i-odine concentration(IC),effective atomic number(Zeff),normalized IC(NIC),normalized Zeff(NZeff),dual energy in-dex(DEI)and slope of energy spectrum curve(λHU)were calculated.The differences in clinical and DECT features be-tween LLNM and non-LLNM group were compared.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of clinical features,DECT features,and the combined model.The area under the ROC curve(AUC),sensitivity and specificity were calculated simultaneously.Results PTC patients who are male,with abnormal Tg and TgAb indica-tors,lesions located at the upper pole,maximum short axis diameter of lesions＞10 mm,and lesions with calcification were prone to LLNM(P＜0.05).Non-contrast NIC in LLNM group were significantly lower than those in non-LLNM group,while arterial and venous phase IC,NIC,and DEI in LLNM group were significantly higher than those in non-LLNM group(P＜0.05).Combination of clinical and DECT features showed the optimal predictive performance(AUC,0.773;sensitiv-ity,84.1％;specificity,65.3％),followed by DECT features(AUC,0.745;sensitivity,79.9％;specificity,67.4％).Both of them outperformed clinical features alone(AUC,0.642;sensitivity,62.6％;specificity,65.3％;P all＜0.05).Conclusion Compared to clinical features,DECT features showed higher predictive value for LLNM in PTC patients.
Papillary thyroid cancerDual energy CTLymph node metastasisIodine concentration
NETL
NSTL
万方数据
