Đặc điểm hình ảnh và giá trị của cắt lớp vi tính trong chẩn đoán hạch cổ di căn ở bệnh nhân ung thư tuyến giáp thể biệt hóa sau phẫu thuật cắt toàn bộ tuyến giáp

Abstract

Objective: To characterize the metastatic cervical lymph nodes and evaluating the value of computed tomography (CT) in the diagnosis of cervical lymph node metastasis in patients with differentiated thyroid cancer after total thyroidectomy and treatment of ¹³¹I. Subject and method: During the period from September 2019 to February 2022, we prospectively studied 280 patients with differentiated thyroid cancer who had undergone total thyroidectomy and treatment of ¹³¹I by contrast enhanced-computer tomography. On radiographs, 556 cervical lymph nodes were detected. Result: Of the total 556 lymph nodes, 374 (67.3%) metastases and 182 (32.7%) benign nodes. The location of metastatic lymph nodes in group VI accounted for the highest rate of 40.4% and group V had the lowest rate of 3.5%. Among the metastatic nodes, 74.1% of the lymph nodes had strong enhancement, 16.0% had signs of necrosis and 17.6% had calcifications. The sign of strong enhancement had a sensitivity of 74.1%, a specificity of 82.4%, a sign of necrosis had a sensitivity of 16.0%, a specificity of 97.3%, a sign of calcification had a sensitivity of 17.6%, specificity 96.7%. Synthesis of signs of CT to diagnose cervical lymph node metastasis had sensitivity 79.4%, specificity 77.5%, accuracy 78.8%. Conclusion: Contrast-enhanced CT is also a valuable method for diagnosing cervical lymph node metastasis in patients with differentiated thyroid cancer after total thyroidectomy.