Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-792, Republic of Korea.
Eur J Surg Oncol. 2013 Feb;39(2):191-6. doi: 10.1016/j.ejso.2012.07.119. Epub 2012 Aug 3.
Adequate evaluation and surgical management of cervical lymph node metastasis is very important in papillary thyroid carcinoma (PTC). The aim of this study was to evaluate the impact of preoperative ultrasonography (US) and computed tomography (CT) on the surgical management of cervical lymph node metastases in PTC.
Medical records and imaging findings were retrospectively analyzed for 252 patients with PTC who underwent thyroidectomy with neck dissection.
The sensitivity of both imaging techniques was lower in the central neck (US 23%, CT 41%) than in the lateral neck (US 70%, CT 82%). The specificities of US and CT were 97% and 90% in the central neck, and 84% and 64% in the lateral neck, respectively. Our surgical plans for therapeutic neck dissection were based on imaging findings in 59% of patients who underwent lateral compartment neck dissection and in 32.1% of patients who underwent central compartment neck dissection, respectively.
The roles of preoperative US and CT in surgical planning for central compartment neck dissection in PTC are limited because of their low sensitivity in the central neck, but US and CT may be useful in cases with non-palpable lateral neck nodes.
充分评估和手术处理甲状腺乳头状癌（PTC）的颈部淋巴结转移非常重要。本研究旨在评估术前超声（US）和计算机断层扫描（CT）对 PTC 颈部淋巴结转移手术管理的影响。
回顾性分析了 252 例行甲状腺切除术和颈部淋巴结清扫术的 PTC 患者的病历和影像学发现。
两种影像学技术在中央颈部的敏感性均较低（US 为 23%，CT 为 41%），而在侧颈部的敏感性较高（US 为 70%，CT 为 82%）。US 和 CT 在中央颈部的特异性分别为 97%和 90%，在侧颈部的特异性分别为 84%和 64%。我们的治疗性颈清扫术手术计划分别基于 59%的侧颈部间隙颈清扫术患者和 32.1%的中央颈部间隙颈清扫术患者的影像学发现。
术前 US 和 CT 在 PTC 中央颈部间隙颈清扫术的手术规划中的作用有限，因为它们在中央颈部的敏感性较低，但 US 和 CT 在触诊不到的侧颈部淋巴结病例中可能有用。
