|
|
|
| Value of CT in diagnosing central lymph node metastasis of papillary thyroid carcinoma |
| LIN Qi-qiang1, HAN Zhi-jiang2, SHU Yan-yan3, CHEN Wen-hui2 |
| 1． 浙江省苍南县第二人民医院放射科，浙江 苍南 325802；2． 杭州市第一人民医院放射科，浙江 杭州 310006；3. 杭州市萧山区第一人民医院放射科，浙江 杭州 311200 |
|
|
|
|
Abstract Objective: To investigate the value of CT in diagnosing central lymph node metastasis of papillary thyroid carcinoma(PTC). Methods: CT data of 625 central lymph nodes with pathological diagnosis in 559 cases were retrospectively analyzed. Positive and negative coincidence rate of CT were evaluated regarding central lymph node metastasis. The distribution of the central lymph node metastasis as cluster nodes, highly enhancement, the minimum diameter/maximum diameter≥1/2, cystic degeneration and microcalcification were observed. The appearance of Hashimoto’s thyroiditis in clustered lymph node group was analysed. Results: In all 625 central lymph nodes, 218 were metastasis. The positive and negative coincidence rate of CT in diagnosing central lymph node metastasis were 59.2%(129/218) and 91.6%(373/407) respectively. The cluster nodes, highly enhancement, the minimum diameter/maximum diameter≥1/2, cystic degeneration were common in lymph node metastasis group. The sensitivity, specificity, positive predictive value and accuracy were 31.7%∶93.5%: 71.1%∶72.7%, 84.1%∶66.7%∶ 86%∶79%, 95.5%∶44.4%∶80.7∶80.6%, 2.5%∶100%∶100%∶67.2% respectively. After combining four CT signs together, the sensitivity, specificity, positive predictive value and accuracy were 59.2%, 88.2%, 72.9% and 78.1%. Microcalcification was only found in 2 central lymph node metastasis groups. In 114 cluster nodes, 31 showed Hashimoto’s thyroiditis, in which 22 were misdiagnosed as lymph node metastasis. Conclusion: CT is of great value in diagnosing central lymph node metastasis. The cluster nodes, obvious enhancement, the minimum diameter/maximum diameter≥1/2, cystic degeneration contribute to the diagnosis of lymph node metastasis. Meanwhile, the central lymph node could be clustered in Hashimoto’s thyroiditis, which calls for clinical attention in order to prevent from being misdiagnosed as metastasis.
|
|
Received: 29 September 2014
|
|
|
|
Corresponding Authors:
HAN Zhi-jiang
|
|
|
|
|
|
|
2015, Vol. 26 
