Objective To compare the difference of diagnostic ability between ultrasound radiomics (USR) and different conventional imaging models of central neck (Ⅵ) lymph node metastasis in papillary thyroid carcinoma (PTC). Methods A training set of 609 cases was set up. USR features were extracted and screened by USR method. A weighted formula was established to calculate the USR score of each patient by ultrasound image. The USR score of the best diagnostic ability was obtained by statistical method and set as the diagnostic criterion. A test set of 326 cases was established to compare the diagnostic ability of USR score with ultrasound (US), computed tomography (CT) and US combined CT. Results The accuracy, sensitivity, specificity, area under ROC curve and Youden index of USR score in test set were 0.804, 0.867, 0.770, 0.766, 0.533, respectively, which were significantly higher than the corresponding values of US, CT and US combined CT(all P=0.000). Conclusions USR score obtained with USR method can effectively predict lymph node metastasis in Ⅵ region of PTC. The diagnostic efficiency and clinical value of USR score were significantly higher than those of conventional medical imaging models. Key words: Ultrasonography; Radiomics; Papillary thyroid carcinoma; Lymph node metastasis; Central neck; Computer tomography