Diagnostic Value Of Color Doppler Ultrasound In Cervical Lymph Nodes Metastases Of Thyroid Carcinoma

Objective To study the major ultrasonographic characteristics and nodal tumor of metastatic lymph nodes, and to explore the distribution of cervical lymph nodes metastases in patients with thyroid carcinoma.Methods Metastatic lymph nodes in 51 patients with thyroid carcinoma were confirmed by operation and pathology between 2007 and 2009, who were examined on ultrasound before operation. Their locations and sonographic features were recorded according to cervical lymph nodes sites. The parameters of 2-Dimensional Ultrasound were observed including Long/short axis, echogenic hilum, With or without hyperechoic punctuations and cystic appearance. The four vascular patterns by Color Doppler were as follows:typeⅠshows central hilar vascularity with radial symmetric branches; typeⅡshows eccentric hilar vascularity with deformed radial branches; typeⅢshows subcapsular vessels (Ⅲa), mixed vessels (Ⅲb), or multifocal hilar vasculature (IIIc); type IVshows spotted or peripheral flow signals. RI was observed by Pulse Doppler.Results (1) A total of 298 lymph nodes were metastatic and 189 were reactive hyperplasia in 51 patients with thyroid carcinoma. Metastatic lymph nodes in patients with thyroid carcinoma were mainly located in regionsⅢ,ⅣandⅡ, regionⅢ71.0%, region IV 54.8% and region 1151.6% respectively. (2) The main 2-Dimensional and color Doppler sonographic features of 298 metastatic lymph nodes were as follows: long/short axis< 2, absence of an echogenic hilum, hyperechoic punctuations, cystic appearance. There were significant differences in above-mentioned sonographic features of the two groups. There were nodal tumors in 11 (3.7%) metastatic lymph nodes. (3) The vascular patterns of 298 metastatic lymph nodes by Color Dopple were of typeⅣ(62.4%) and typeⅢb (24.2%). The distribution of RI in 298 metastatic lymph nodes as follows:high-resistant spectrum 27.3%, RI:0.81+0.09(0.70-1.0), middle-resistant spectrum 18.2%, RI:0.63±0.02 (0.61-0.65), low-resistant spectrum 54.5%, RI: 0.47±0.06 (0.34-0.60) Conclusions The locations, the major 2-Dimensional ultrasonographic characteristics, and internal vascular patterns of cervical metastatic lymph nodes in patients with thyroid carcinoma help distinguish between metastatic and reactive hyperplasia lymph nodes.