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Diagnosis of Cervical Metastatic Lymph Nodes in
Papillary Thyroid Carcinoma: Is CT Enhancement Useful
for Diagnosing Lymph Node Metastasis? |
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Hyun Joo Shin, MD, Eun-Kyung Kim, MD, Hee Jung Moon, MD,
Jin Young Kwak, MD |
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Department of Radiology, Yonsei University College of Medicine |
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Purpose: We wanted to determine the utility of CT enhancement for diagnosing
metastatic lymphadenopathy in patients with papillary thyroid carcinoma (PTC), and
especially in the lymph nodes (LNs) of the lateral neck level and that are not suspicious
for metastasis on ultrasonography (US).
Materials and Methods: Our study population included 34 consecutive LNs of 31
patients (25 females and 6 males, mean age: 46.7 yrs) with PTC and who had no
suspicious metastatic lateral cervical LN on preoperative US, but enhancement of the
lateral cervical LNs was seen on CT. To objectify the degree of enhancement, the difference
of Hounsfield units between the suspicious LN and that of the ipsilateral SCM
muscle was calculated. For the node-by-node analysis, marking of the corresponding
LN with CT enhancement on the second look US was performed. The final assessment
was attained by surgical dissection of the marked LNs. The medical records
were reviewed for the patients’ age and gender and the size of the LNs.
Results: Among the 34 LNs, 17 LNs were diagnosed as metastasis and 17 were
benign. There was no difference in the size of the LNs between two the groups
(benign and metastatic). The patients who had metastatic LNs were younger than
those patients with benign LNs (p = 0.037). The incidence of metastatic LN was higher
in the male patients than in the female patients (F:M = 38.5%:100%, p = 0.018).
There was no statistical difference between the metastatic LNs and benign LNs
according to the degree of enhancement (p = 0.953).
Conclusion: The degree of CT enhancement is not feasible to use for diagnosing
metastatic LNs in the lateral neck level in patients with PTC. |
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Keyword : Papillary thyroid carcinoma; Computed tomography (CT); |
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pdf파일 : 187-191신현주.pdf
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