Abstract
Cervical lymph node metastasis (CLNM) is common in patients with papillary thyroid carcinoma (PTC), which is responsible for tumor staging and surgical strategy. The accurate preoperative identification of CLNM is essential. In this study, twenty consecutive patients with PTC received a parenchyma injection of Sonazoid followed by contrast enhanced ultrasound (CEUS) to identify CLNM. The specific lymphatic CEUS (LCEUS) signs for diagnosing CLNM were summarized, which were further compared with the resected specimens to get the pathological basis. After the injection of contrast agent, lymphatic vessel and lymph node (LN) could be exclusively displayed as hyperperfusion on LCEUS. The dynamic perfusion process of contrast agent in CLNM over time can be clearly visualized. Perfusion defect and interruption of bright ring were the two characteristic LCEUS signs in diagnosing CLNM. After comparing with pathology, perfusion defect was correlated to the metastatic foci in medulla and interruption of bright ring was correlated to the tumor seeding in marginal sinus (all p values < 0.001). The diagnostic efficacies of these two signs were high (perfusion defect vs. interruption of bright ring: AUC, 0.899, 95% CI 0.752–1.000 vs. 0.904, 0.803–1.000). LCEUS has advantages in identifying CLNM from PTC. The typical LCEUS signs of CLNM correlated with pathology.
Highlights
Cervical lymph node metastasis (CLNM) often occurs in patients with papillary thyroid carcinoma (PTC), which is responsible for tumor staging and surgical s trategy[1,2,3,4]
The typical signs of metastasis encountered in only a few cases, it is difficult to make definite diagnosis in most cases when there is small metastatic foci inside lymph node (LN)[9, 10]
Intravenous contrast enhanced ultrasound (IVCEUS), which is able to reveal tissue microvascularization, is used to identify CLNM r ecently[11]. It often does not work because it’s difficult to identify the slight differences of enhancement between the minor metastatic foci and the surrounding lymphatic parenchyma in LNs attributed to the indolent feature of PTC
Summary
Cervical lymph node metastasis (CLNM) often occurs in patients with papillary thyroid carcinoma (PTC), which is responsible for tumor staging and surgical s trategy[1,2,3,4]. Intravenous contrast enhanced ultrasound (IVCEUS), which is able to reveal tissue microvascularization, is used to identify CLNM r ecently[11]. It often does not work because it’s difficult to identify the slight differences of enhancement between the minor metastatic foci and the surrounding lymphatic parenchyma in LNs attributed to the indolent feature of PTC. Several studies reported the use of lymphatic contrast enhanced ultrasound (LCEUS) to identify lymphatic vessels and sentinel lymph nodes in breast cancer and melanoma after peritumoral injections of the US contrast agent S onazoid[13,14,15]. The purpose of present study is to summarize the characteristic LCEUS signs, as well as the pathological basis for the diagnosis of CLNM in PTC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
