Diagnostic value of contrast-enhanced ultrasound and elastography in cervical lymph node metastasis of elderly papillary thyroid carcinoma
WU Yifeng1 YU Xiuhua1 HU Jun2 YAN Yan3▲
1.Department of Special Diagnosis, the 903rd Hospital of PLA, Zhejiang Province, Hangzhou 310000, China;
2.Department of Ultrasound Intervention, Zhejiang Integrated Hospital of Traditional Chinese and Western Medicine, Zhejiang Province, Hangzhou 310003，China; 3.Department of Ultrasound, the Second People′s Hospital of Nantong, Jiangsu Province, Nantong 226002, China
Abstract：Objective To evaluate the clinical application value of contrast-enhanced ultrasound and elastography in the diagnosis of cervical lymph node metastasis of elderly papillary thyroid carcinoma (PTC). Method A total of 117 elderly PTC patients (183 nodules) who admitted to Department of Special Diagnosis, 903rd Hospital of PLA from May 2015 to May 2017 were selected as the study objects. Contrast-enhanced ultrasound and ultrasound elastography were performed, and postoperative pathological results were used as the gold standard. According to whether PTC has lymph node metastasis, they were divided into metastasis group of 45 cases (74 nodules) and non metastasis group of 72 cases (109 nodules). Quantitative parameters, elastic strain rate and elastic score between the two groups were compared. The accuracy, specificity, sensitivity, negative and positive predictive value of contrast-enhanced ultrasound, elastography and their combination in the diagnosis of cervical lymph node metastasis of PTC were compared. The value of ultrasonography and elastography in the prediction of cervical lymph node metastasis of PTC were evaluated. Results The peak intensity of metastasis group was higher than that of non metastasis group, and the difference was statistically significant (P < 0.05). The elastic strain rate of metastasis group was higher than that of non metastasis group, and the difference was statistically significant (P < 0.05). SR predicted that the area under the curve of PTC cervical lymph node metastasis was greater than PI. The accuracy, sensitivity and negative predictive value of contrast-enhanced ultrasound combined with elastography in the diagnosis of cervical lymph node metastasis of PTC were higher than those of contrast-enhanced ultrasound or elastography alone. Conclusion Contrast-enhanced ultrasound and elastography have certain diagnostic value for cervical lymph node metastasis of PTC. The combination of them can effectively improve the diagnostic accuracy and has higher clinical application value.
2020, Vol. 17 
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