Objective:

To explore the clinical value of high-frequency color Doppler ultrasonography in the differential diagnosis of metastatic lymph nodes from reactive proliferative lymph nodes in thyroid carcinoma.

Methods:

A total of 256 patients with th

yroid cancer confirmed by surgical pathology were selected and they underwent cervical high-frequency ultrasonography. The accuracy of high-frequency ultrasound in diagnosis of metastatic lymph nodes was calculated. The ultrasonographic features

classification of blood flow pattern and neck distribution between metastatic lymph nodes and reactive proliferative lymph nodes were compared. The resistance index (RI) of metastatic lymph nodes was recorded.

Results:

The pathological results showed 1 496 metastatic lymph nodes and 949 reactive proliferative lymph nodes in 256 patients. The high-frequency color Doppler ultrasound diagnosed 1 329 metastatic lymph nodes and 1 116 reactive proliferative lymph nodes

with an accuracy of 91.21% (2 230/2 445). The proportion of disappearance of hyper-echogenic hilus was 86.90% in metastatic lymph nodes

which significantlyhigher than that in reactive proliferative lymph nodes (14.01%) (

P

0.05). Among metastatic lymph nodes

14.71% showed cystic degeneration

35.90% were dotted hyperechoic

and 42.78% had peripheral blood flow. The above symptoms were not shown in reactive proliferative lymph nodes. The morphological types of metastatic lymph nodes were type Ⅲ and type Ⅳ

and the reactive proliferative lymph nodes were predominantly presented type Ⅰ. There was no regularity in the distribution of reactive proliferative lymph nodes. But it was common for metastatic lymph nodes to appear in Ⅱ

Ⅲ and Ⅳ area. In 1 496 metastatic lymph nodes

26.87% was high-resistance type

17.45% was medium-resistance type

and 55.68% was low-resistance type.

Conclusion:

There is certain regularity in the distribution of metastatic lymph nodes of thyroid cancer. There are differences in cystic degeneration

dotted hyperecho

peripheral blood flow

disappearance of hyper-echogenic hilus between metastatic lymph nodes and reactive proliferative lymph nodes. Comprehensive analysis combined with lymph node border

internal echo

blood flow on high-frequency c

olor Doppler ultrasound is helpful in the identification of lymph node properties.