Purpose: To investigate the characteristics of lymph node (LN) metastasis of papillary thyroid carcinoma (PTC) with ultrasonography (US) and spiral computed tomography (CT) and the significance of their combination in the diagnosis and prognosis of LN metastasis.
Methods: A total of 93 PTC patients admitted to and treated in the oncology department of our hospital were randomly enrolled in this study. LN imaging signs were explored by US, CT and their combination. Through the comparison with pathological findings, the diagnostic efficiency of three methods in LN metastasis in patients with PTC was analyzed. Postoperatively, all patients were followed up for 1-3 years to analyze the relationship between LN metastasis and the prognosis of PTC.
Results: Among 93 PTC patients, 69 (74.19%) had LN metastasis, and 24 (25.81%) had not. US examination revealed that metastatic LN were hypoechoic and obviously calcified, and had aspect ratio >1 and strong blood flow signals. Among them, there were significant differences in calcification and blood flow between LN metastasis group and non-metastasis group (p<0.05). CT images indicated that metastatic LN were swollen, had low-density and were calcified with abundant blood flow signals. In addition, the edge, calcification and CT reinforced examination showed obvious differences between the LN metastasis group and the non-metastasis group (p<0.05). The sensitivity, specificity and accuracy of US alone in the diagnosis of LN metastasis were clearly better than those of CT alone (p<0.05), while their combination was better than both US and CT alone in the sensitivity, specificity and accuracy in the diagnosis of LN metastasis (p<0.05). Follow-up data suggested that the 3-year recurrence or metastasis rates of patients in the metastasis and non-metastasis groups were 4.54 and 11.27%, respectively, showing a statistically significant difference (p<0.05).
Conclusions: US combined with CT can make up for the deficiencies of each examination alone, and improve the sensitivity and specificity of PTC LN metastasis detection. It is worthy of clinical promotion.
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