Exploration of the Evaluation Value of Combined Magnetic Resonance Imaging and Ultrasound Blood Flow Parameters in Cervical Lymph Node Metastasis of Thyroid Cancer.

IF 2.5 4区医学 Q3 ONCOLOGY

Cancer Management and Research Pub Date : 2025-03-20 eCollection Date: 2025-01-01 DOI:10.2147/CMAR.S505730

Xiaosong Sun, Zhengchao Wei, Yiqiang Luo, Ming Wang

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引用次数: 0

Abstract

Background: Thyroid cancer exhibits the highest cervical lymph node metastasis rate (20-50%) among head and neck malignancies, with occult metastasis occurring in 30-80% of papillary carcinoma cases. However, conventional single-modality imaging faces certain challenges: MRI has limited sensitivity for detecting micro-metastases (<2mm), while Doppler ultrasound may overlook metastases in isoechoic lymph nodes. Therefore, it is crucial to evaluate the diagnostic value of combining MRI and CDUS. This study aims to retrospectively analyze the diagnostic value of combining MRI and CDUS blood flow parameters in detecting cervical lymph node metastasis in thyroid cancer and to compare the diagnostic performance with MRI or CDUS alone.

Objective: To analyze the evaluation value of combining MRI and color Doppler ultrasound (CDUS) blood flow parameters in detecting cervical lymph node metastasis of thyroid cancer, particularly for occult metastases.

Methods: A retrospective analysis was conducted on 263 thyroid cancer patients (June 2022-June 2024). Diagnostic consistency between MRI, CDUS parameters (resistive index, pulsatility index, vascular patterns) and pathology were compared. Multimodal evaluation criteria were established: (1) MRI positive signs (lymph node diameter >8mm, cystic change, enhancement heterogeneity) (2) CDUS thresholds (RI≥0.75, PI≥1.25 with chaotic vascularity).

Results: Among 263 patients, 98 had pathologically confirmed metastases. CDUS showed higher consistency with pathology (Kappa=0.783) than MRI (Kappa=0.645). Combined modality achieved 94.9% sensitivity vs 86.7% (CDUS) and 78.6% (MRI), with accuracy improving from 82.1%/75.3% to 89.4% (P<0.05). Notably, 12/22 occult metastases (≤3mm) were only detected by combined approach.

Conclusion: The synergistic combination leverages MRI's structural characterization and CDUS's hemodynamic sensitivity, effectively overcoming single-modality limitations in detecting micro-metastases. This dual-assessment protocol addresses thyroid cancer's propensity for early lymphatic spread, providing critical preoperative staging guidance.

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磁共振成像与超声血流参数联合评价甲状腺癌颈部淋巴结转移的价值探讨。

背景：甲状腺癌在头颈部恶性肿瘤中颈部淋巴结转移率最高（20-50%），30-80%乳头状癌发生隐匿转移。然而，传统的单模成像面临着一定的挑战：MRI对微小转移的检测灵敏度有限(目的：分析MRI与彩色多普勒超声（CDUS）血流参数联合检测甲状腺癌颈部淋巴结转移，特别是对隐匿性转移的评价价值。方法：对2022年6月~ 2024年6月263例甲状腺癌患者进行回顾性分析。比较MRI、CDUS参数（电阻指数、搏动指数、血管形态）和病理诊断的一致性。建立多模式评价标准：(1)MRI阳性征象（淋巴结直径> ~ 8mm，囊性改变，增强异质性）(2)CDUS阈值（RI≥0.75,PI≥1.25伴混沌血管）。结果：263例患者中，病理证实转移98例。CDUS与病理的一致性（Kappa=0.783）高于MRI （Kappa=0.645）。联合模式的灵敏度为94.9%，而CDUS为86.7%，MRI为78.6%，准确率从82.1%/75.3%提高到89.4%(结论：协同联合利用了MRI的结构表征和CDUS的血流动力学敏感性，有效克服了单一模式在检测微转移方面的局限性。这种双重评估方案解决了甲状腺癌早期淋巴扩散的倾向，提供了关键的术前分期指导。

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来源期刊

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.