Real-time tissue elastography as a evaluation of the assessment of papillary thyroid papillary carcinoma with cervical lymph node metastasis

Abstract

Objective To compare real-time tissue elastography (RTE) and ultrasound in the diagnosis of papillary thyroid carcinoma (PTC) with cervical lymph node (LN) metastasis. Methods A retrospective analysis was carried out on the clinical data of 72 patients with PTC.Eighty-four LNs of them were performed with ultrasound-guided fine-needle aspiration biopsy.Patients were divided into two groups: with cervical lymph node metastasis group and without cervical lymph node metastasis group.All patients were reviewed their B-mode ultrasonography (BUS) on cervical lymph node and RTE on thyroid.RTE elasticity indices (EI) of mean (Emean), minimum (Emin), maximum (Emax) and the ratio of Emean in LNs and surrounding muscle (Emean-m) were measured at the thyroids.The performances of RTE and BUS in predicting of PTC with LN metastasis were compared and analyzed. Results The sensitivity and specificity of BUS on diagnosis of the cervical lymph nodes metastasis were 84.0% and 90.0%.The RTE Emea, Emax, Emin and SI in meta-static LNs were significantly higher than those in benign LNs(P=0.001, 0.002, 0.001, 0.007). The RTE results of PTC patients with lymph node metastasis was analyzed by ROC curve.The largest area was Emin.AUC was 0.918, the critical value was 0.240.AUC of SI was 0.896, AUC of Emean was 0.718, AUC of Emax was 0.670.The sensitivity and specificity were 94.0% and 99.4%, respectively. Conclusion Co-operation of RTE and BUS was more accurate than simple BUS in diagnosis of PTC with lymph node metastasis.SI and Emin has a high diagnostic value. Key words: Thyroid neoplasms; Ultrasonography; Neoplasm metastasis; Lymphatic metastasis