Diagnostic accuracy of CT and ultrasonography for evaluating metastatic cervical lymph nodes in patients with thyroid cancer
Diagnostic accuracy of CT and ultrasonography for evaluating metastatic cervical lymph nodes in patients with thyroid cancer
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DOI：
10.1007/s00268-008-9588-7
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发表时间：
2008-07-01
影响因子：
2.6
通讯作者：
Kim, Sang Joon
中科院分区：
文献类型：
--
作者：
Ahn, Ji Eun;Lee, Jeong Hyun;Kim, Sang Joon
本研究旨在探讨计算机断层扫描（CT）和超声检查（USG）在术前评估甲状腺癌患者宫颈结状态中的诊断能力。方法研究人群包括37例连续的甲状腺癌患者（女：男= 30:7，年龄范围：20-68岁），他们随后接受了甲状腺全切除术和颈部清扫术。复习术前CT和原始USG报告的结果与组织病理学结果进行比较。准确度通过“每个水平”和“每个患者”分析CT或USG结果是否改变了手术方法的选择来评估。结果经“每水平”分析，CT的敏感性、特异性和诊断准确率分别为77%、70%、74%，USG的敏感性、特异性和诊断准确率分别为62%、79%、68%，两者敏感性差异有统计学意义（p = 0.002）。当将淋巴结水平分为中央和外侧隔室时，外侧隔室的所有值都倾向于高于CT（78%, 78%， 78%比74%，44%,64%）和USG（65%, 82%， 71比55%，69%,60%）的中央隔室的值。通过对每例患者的分析，CT和USG的敏感性、特异性和诊断准确率分别为100%、90%、97%和100%、80%、95%。结论尽管单例分析的USG准确度很高，但CT在单水平分析上的优越敏感性可以使CT在确定选定的甲状腺癌患者的手术范围方面发挥补充作用。
Background The present study was designed to investigate the diagnostic ability of computed tomography (CT) and ultrasonography (USG) in the preoperative evaluation of the cervical nodal status of patients with thyroid cancer.Methods The study population consisted of 37 consecutive patients (female:male = 30:7, age range: 20-68 years) who subsequently underwent total thyroidectomy and neck dissection for thyroid cancer. The results of the review of the preoperative CT and those of the original USG reports were compared with the histopathologic results. The accuracy was evaluated by "per level" and "per patient" analyses of whether the CT or USG results had or had not altered the choice of surgical method.Results By "per level" analysis, the sensitivities, specificities, and diagnostic accuracies were 77%, 70%, 74% for CT and 62%, 79%, 68% for USG, respectively, with a significant difference in the sensitivities (p = 0.002). When the lymph node levels were grouped into central and lateral compartments, all of the values for the lateral compartment tended to be higher than those for the central compartment for both CT (78%, 78%, 78% versus 74%, 44%, 64%) and USG (65%, 82%, 71 versus 55%, 69%, 60%). By per patient analysis, the sensitivities, specificities, and diagnostic accuracies of CT and USG were 100%, 90%, 97% and 100%, 80%, 95%, respectively.Conclusion Despite of very high accuracy of USG by per patient analysis, the superior sensitivity of CT on the per level analysis may enable CT to play a complementary role for determining the surgical extent in selected patients with thyroid cancer.