Role of preoperative ultrsonography in evaluating cervical metastasis in patients with differentiated thyroid carcinoma / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To evaluate the role ofpreoperative ultrasonograpy in detecting cervical lymph node metastasis. METHODS Medical records between February 1998 and February 2002,consisting of 51 cases (58 sides) of well-differentiated thyroid carcinoma with cervical lymph nodes metastasis, were reviewed. Patients were divided into 2 groups group 1,34 cervical sides with palpable cervical lymph nodes preoperatively and group 2,24 cervical sides with impalpable nodes but positive for nodal metastasis ultrasonically. All patients underwent modified neck dissection. The preoperative ultrsonographic results and preoperative pathologic findings were compared. RESULTS Of the 58 sides with positive preoperative ultrsonographic results, 53 sides had been demonstrated to have cervical lymph nodes metastasis pathologically. The sensitivity of ultraonography was 91.4 %(53/58). Four patients had developed lateral cervical recurrence during the course of the follow-up, yielding a recurrence rate of 7.5 %. Ultrasonography detected cervical lymph node believed to be uninvolved by physical examination in 39.6 % of patients. The most frequent involvement site was middle neck according to ultrasonography [71.7 %(38/53)] and level Ⅲ according to pathological findings [67.9 %(36/53)]. CONCLUSION Preoperative ultrasonograpy is a basis for detecting cervical lymph nodes metastasis in thyroid cancer patients. It can detect metastatic cervical lymph nodes and their localizations. All thyroid cancer patients should undergo preoperative ultrasonography.