Conventional Ultrasound And Contrast-enhanced Angiography Of Papillary Thyroid Carcinoma Correlation Between Cervical Lymph Node Metastasis

Objective: To investigate the characteristics of conventional ultrasound(US)and Contrast enhanced ultrasound(CEUS)and cervical lymph node metastasis in the primary tumor nodules of papillary thyroid carcinoma(PTC)before surgery.improve the risk of preoperative prediction of PTC cervical lymph node metastasis(CLNM),provide an effective diagnostic basis for the choice of clinical treatment options and the rational development of surgical neck lymph node dissection.Materials and Methods: A total of192 PTC patients from the First Affiliated Hospital of Xinjiang Medical University from April 2017 to June 1818 were enrolled in this study for retrospective analysis.All patients underwent surgical treatment and obtained thyroid nodules.Pathological results,at the same time,each patient underwent cervical lymph node dissection and obtained lymph node pathology results.Preoperative ultrasound and contrast-enhanced ultrasonography were performed before the operation,and complete ultrasound image data were obtained.Preoperative ultrasound data and postoperative pathological analysis were collected.This study was based on the negative and positive pathological results of cervical lymph nodes after PTC,and was divided into metastatic group(n=52 cases,76 PTC nodules)and nonmetastasis group(n=80 cases,116 PTC nodules).Conventional ultrasound features of PTC(aspect ratio,cancer nodule size,ultrasound boundary of cancer nodules,calcification characteristics in cancer nodules,relationship between cancer nodules and thyroid capsule,distribution of blood flow signals in cancer nodules,cancer nodes)Total number of lesions,left/right leaf,specific location,internal echo of cancer nodules,thyroid background of cancer nodules)and contrast-enhanced features(enhancement time,enhancement level,contrast agent distribution characteristics,regression mode)and related clinical basicsData(age,gender,ethnicity)and cervical lymph node metastasis were analyzed by single factor analysis,and the pathological diagnosis of cervical lymph node metastasis was used as the dependent variable.The conventional ultrasound features of PTC cancer nodules,contrast-enhanced ultrasound features and related clinical data were obtained.For the independent variables,a logistic regression model was established,multivariate analysis was performed,and the metastatic group was grouped at the same time to investigate the correlation between the ultrasound features of PTC cancer nodules.Results: 1.Univariate analysis showed that the boundary of cancer nodules,the relationship between cancer nodules and thyroid capsule,the characteristics of calcification,the thyroid background of cancer nodules,the size of cancer nodules and the sex of patients were related to CLNM.The difference was statistically significant(P<0.05);that is,the boundary of the cancer nodules in the ultrasound features was unclear,the thyroid capsule was discontinuous,multiple coarse calcifications,nodular goiter background,nodules ?1 cm,and the patient was Males were risk factors for CLNM,and the difference was statistically significant(P< 0.05).2.Multivariate analysis showed that the thyroid background of the cancer nodules,the blood flow signal in the cancer nodules,the ultrasound boundary of the cancer nodules and the sex of the patients were related to the occurrence of CLNM,which was the risk predictor of cervical lymph node metastasis.Statistical significance(P<0.05),that is,when the PTC cancer nodules showed dendritic or abundant blood flow signals,the ultrasound boundary was unclear,the nodular goiter background,and the male patients were more likely to have lymph node metastasis.3.The metastatic group was analyzed by subregional analysis of PTC cancer nodules.The correlation between conventional ultrasound and contrast-enhanced ultrasonography and pathological diagnosis of cervical lymph node metastasis showed that the number of lesions,thyroid background,contrastenhanced ultrasound pattern and cervical lymph node metastasis had Correlation,the difference was statistically significant(P<0.05).Conclusion: Conventional ultrasound features have a certain significance in predicting the risk of PTC cancer nodules CLNM before surgery.Combined ultrasound contrast imaging improves the ability to predict the risk of PTC cancer nodules CLNM before surgery.