Value of conventional ultrasound combined with shear-wave elastography in prediction of extradenocarcinoma of thyroid papillary carcinoma and lymph node metastasis in the central region of neck
Objective To investigate the value of multimodal ultrasonography in the prediction of extragad-enial invasion and lymph node metastasis of papillary thyroid carcinoma(PTC).Methods 120 patients with PTC who underwent lymph node dissection in central region of neck in the hospitalfrom January 2022 to January 2024 were studied.Imaging examinations were performed on all PTC patients with HI VISION Preirus color Doppler ultrasound,and the maximum diameter,boundary,horizontal and horizontal col-umn ratio,micro-calcification,maximum Young's modulus(Emax)and standard deviation(Esd)of shear wave elastic imaging were recorded.The patient record system was consulted to collect gender,age,tumor family history and nodule site of all patients.Intraoperative or postoperative pathological findings were used to evaluate the presence or absence of PTC extrandular invasion.Lymph node metastasis in the central region of the neck was determined by postoperative pathology.Results Of the 120 PTC patients,48 cases had extraducular invasion and 72 cases had no extraducular invasion.There were 43 cases with lymph node metastasis and 77 cases without lymph node metastasis.There were no significant differences in gender,age,family history of tumor,and nodule location in patients with or without extrandular inva-sion of PTC and with or without lymph node metastasis(P>0.05).Compared with the patients without extrandular invasion,the maximum diameter of nodules in patients with extrandular invasion was signifi-cantly increased,and Emax and Esd were significantly increased,with statistical significance(P<0.05).Compared with patients without lymph node metastasis,the maximum diameter of nodules,the propor-tion of microcalcification and Esd were significantly increased in patients with lymph node metastasis,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that maximum nodule diameter and elastic imaging Esd were independent risk factors for PTC extrandular invasion(P<0.05),and microcalcification and elastic imaging Esd were independent risk factors for lymph node metastasis of PTC(P<0.05).ROC curve analysis showed that the AUC of the maximum nodule diameter and elastic imaging Esd to predict the extrandular invasion of PTC was 0.828(95%CI=0.756~0.901),and the sensitivity and specificity were 70.8%and 77.8%,respectively.The AUC of mi-crocalcification and elastic imaging Esd for predicting PTC lymph node metastasis was 0.844(95%CI=0.769~0.919),and the sensitivity and specificity were 72.9%and 88.9%,respectively.Conclusion The characteristics and parameters of multimodal ultrasonography are valuable in the diagnosis of extradenocar-cinoma of thyroid papillary carcinoma and lymph node metastasis in the central region of neck.