A Study Of The Clinical Application Of Ultrasonography And DWI In The Assessment Of Thyroid Cancer And Cervical Lymph Node Metastasis

Objective: To compare the two detecting methods of Color Doppler Ultrasonography and Diffusion Weighted Imaging(DWI) in diagnosing thyroid carcinoma and the cervical lymph nodes metastases of thyroid carcinoma.Method: The imaging data and pathologic data of 265 immunohistochemicalsurgical cases were retrospectively analysed treated by the same group of Thyroid and Breast Surgery department at Wuhan Tongji Hospital during the period of September 2014 to December 2015. These cases included 65 male and 200 females patients with their average age being 12-76 and median age being43.9. Among them, 111 thyroid carcinoma patients were treated with cervical lymph nodes dissection. All cases were examined by Color Doppler Ultrasonography as well as DWI, and the diagnosis results were compared with the pathologic data after surgery to determine the sensitivity and specificity of these two methods in diagnosing thyroid carcinoma and the cervical lymph nodes metastases of thyroid carcinoma. Statistical analysis was performed with the chi-square test.Results: Of all 265 cases, the pathologic results after surgery showed that 181 cases were malignant nodules and 84 cases were benign nodules. Color Doppler Ultrasonography examination showed 186 cases were malignant nodules, 154 cases of which being consistent with the pathologic results, and 79 cases were benign nodules, 52 cases of which being consistent with the pathologic results. The sensitivity and specificity of Color Doppler Ultrasonography were therefore 85.08%(154/181) and 61.90%(52/84) respectively. In the same calculation method, the sensitivity and specificity of DWI/MRIwere 87.29%(158/181) and 77.38%(65/84) respectively. Through chi-square test, the P values of sensitivity(0.6265) and specificity(0.0801) between these two methods were all greater than 0.05, hinting that there was no significant difference in determining the nature of thyroid nodules between Color Doppler Ultrasonography and DWI.Among thyroid carcinoma cases, 111 patients were treated with cervical lymph nodes dissection. The pathologic results after surgery showed that 67 cases had cervical lymph nodes metastases. Color Doppler Ultrasonography examination showed 59 cases had cervical lymph nodes metastases, 42 cases of which being consistent with the pathologic results, and 52 cases were negative, 27 cases of which being consistent with the pathologic results. The sensitivity and specificity of Color Doppler Ultrasonography were therefore 62.69%(42/67) and 61.36%(27/44) respectively. In the same calculation method, the sensitivity and specificity of DWI/MRIwere 88.06%(59/67) and 36.36%(16/44) respectively. Through chi-square test, the P values of sensitivity(0.0005) and specificity(0.0098) between these two methods were all less than 0.05, hinting that the sensitivity of DWI was markedly higher than Color Doppler Ultrasonography in diagnosing the cervical lymph nodes metastases.Conclusion: The results revealed that there was no significant difference in diagnosing thyroid carcinoma between Color Doppler Ultrasonography and DWI. However, the sensitivity of DWI was markedly higher than Color Doppler Ultrasonography in diagnosing the cervical lymph nodes metastases of thyroid carcinoma but with relatively low specificity. In conclusion, DWI applies to the assessment of cervical lymph nodes in thyroid carcinoma cases.