Xiaosong Sun, Zhengchao Wei, Yiqiang Luo, Ming Wang
{"title":"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。","authors":"Xiaosong Sun, Zhengchao Wei, Yiqiang Luo, Ming Wang","doi":"10.2147/CMAR.S505730","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"651-659"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932127/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exploration of the Evaluation Value of Combined Magnetic Resonance Imaging and Ultrasound Blood Flow Parameters in Cervical Lymph Node Metastasis of Thyroid Cancer.\",\"authors\":\"Xiaosong Sun, Zhengchao Wei, Yiqiang Luo, Ming Wang\",\"doi\":\"10.2147/CMAR.S505730\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The synergistic combination leverages MRI's structural characterization and CDUS's hemodynamic sensitivity, effectively overcoming single-modality limitations in detecting micro-metastases. 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Exploration of the Evaluation Value of Combined Magnetic Resonance Imaging and Ultrasound Blood Flow Parameters in Cervical Lymph Node Metastasis of Thyroid Cancer.
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.
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.
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