Evaluation of preoperative central lymph node metastasis in patients with papillary thyroid carcinoma by multimodal ultrasound techniques
Objective To evaluate the accuracy of multimodal ultrasound in predicting preoperative central lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods A total of 108 patients with thyroid nodules performed sur-gical treatment were enrolled,which included 19 males and 89 females,aged 20-77 years old with mean age of 47.1 years old;diameter of nodules was 1.0-2.6 cm with mean diameter of 1.9 cm.All of them were pathologically diagnosed as PTC,and preoperative multimodal ultrasound examination was performed,which included conventional two-dimensional ultrasound,contrast-enhanced ultrasound(CEUS)and micro-flow imaging(MFI).According to CLNM,all of them were divided into non-metastasis group and metastasis group.The pathological characteristics and ultrasonic characteristics of 2 groups were record ed,and independent risk factors of CLNM in PTC patients were analyzed.The receiver operating characteristic(ROC)curve was drawn to evaluate the specificity,sensitivity and accuracy of multimodal ultrasound,and various diagnostic models were applied and compared to evaluate its accuracy.Results The CLNM was pathologically diagnosed in 43 cases(39.8％).Logis-tic regression analysis showed that the independent risk factors for CLNM were contact between nodules and capsule by two-di-mensional ultrasound,nodule diameter ≥ 0.8 cm,central blood flow distribution mode by MFI,contact between nodules and cap-sule by CEUS and centripetal perfusion(P＜0.05).The accuracy of multimodal ultrasound in predicting CLNM risk was sig-nificantly better than that of single detection mode.The sensitivity,specificity and accuracy of multimodal ultrasound were 76.7％,81.5％and 80.2％,respectively,and the difference was statistically significant than other 3 modes(P＜0.05).Conclu-sion It is demonstrated that the combination of MFI,CEUS,and two-dimensional ultrasound could more accurately predict the preoperative cervical lymph node metastasis of PTC.
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