超声联合CT增强扫描对甲状腺乳头状癌术前颈部淋巴结转移的诊断价值OA

Objective:To investigate the diagnostic value of ultrasound combined with contrast-enhanced CT for preoperative cervical lymph node metastasis(CLNM)in papillary thyroid carcinoma(PTC).Methods:A total of 82 PTC patients who underwent preoperative ultrasound and cervical CT scan were retrospectively selected.Taking the surgical pathological results as the gold standard,82 patients were divided into the CLNM group(50 cases)and the non-CLNM group(32 cases).The ultrasonic and cervical CT characteristics of the two groups were analyzed.The diagnostic accuracy,sensitivity,specificity,and consistency rate of ultrasound,CT examination,and their combination were compared.Results:The proportions of calcification,aspect ratio<2,cystic change,and characteristic blood flow in the CLNM group were higher than those in the non-CLNM group,while the proportion of an echogenic hilum was lower(all P<0.05).The proportions of cystic lesions,adjacent tissue invasion,region Ⅳ CLN diameter>5 mm,heterogeneous enhancement and obvious enhancement in the CLNM group were significantly higher than those in the non-CLNM group(all P<0.05).For the diagnosis of CLNM,the sensitivities of ultrasound,contrast-enhanced CT and their combination were 74.00％(37/50),78.00％(39/50)and 86.00％(43/50),the specificities were 75.00％(24/32),78.12％(25/32)and 84.38％(27/32),the accuracies were 74.39％(61/82),78.05％(64/82)and 85.37％(70/82),and the K values were 0.420,0.549 and 0.696,respectively.There were no statistically significant differences in the consistency rates of ultrasound,contrast-enhanced CT or their combination in diagnosing metastases in the central or lateral cervical compartments(both P>0.05).Conclusions:Ultrasound can effectively identify characteristics such as calcification and cystic change of CLN,while contrast-enhanced CT can effectively identify cystic lesions and adjacent tissue invasion.The combination of the two in PTC patients can improve the sensitivity,specificity and accuracy of preoperative CLNM diagnosis,and has certain guiding value for clinical formulation and adjustment of PTC treatment plans.