title: Diagnostic accuracy of ultrasonographic features for lymph node metastasis in papillary thyroid microcarcinoma: a single-center retrospective study.
abstract: BACKGROUND
  Whether sonography is an appropriate imaging modality for cervical lymph nodes in patients with papillary thyroid microcarcinoma (PTMC) remains unclear. Hence, this study aimed to evaluate the diagnostic value of ultrasonography (US) features for lymph node metastasis in PTMC.
  
  
  METHODS
  Seven hundred twelve patients with PTMC who underwent conventional ultrasonography examinations of the cervical lymph nodes were included. All included cases underwent total thyroidectomy plus prophylactic central lymph node dissection. The included lymph nodes were marked superficially, and the corresponding lymph nodes were completely removed and sent for pathological examination. The US features of lymph nodes with and without metastasis were compared, and the odds ratios of the suspicious US features were determined with univariate and multivariate analyses.
  
  
  RESULTS
  Round shape, loss of an echogenic fatty hilum, cystic change, calcification, and abnormal vascularity were significantly more common in metastatic than nonmetastatic lymph nodes, whereas the boundary and echo did not significantly differ. Multivariate logistic regression analysis showed that round shape, loss of echogenic fatty hilum, cystic change, calcification, and abnormal vascularity were independent predictive factors for the assessment of metastatic lymph nodes. Round shape had the highest sensitivity of all variables, while loss of an echogenic fatty hilum had the highest specificity and accuracy. The area under the receiver operating characteristic curve, which was calculated to verify the relationship between the various US features and metastatic lymph nodes, was 0.793.
  
  
  CONCLUSIONS
  Our study found that the US features of round shape, cystic change, calcification, loss of echogenic fatty hilum, and abnormal vascularity were useful sonographic criteria for differentiating between cervical lymph nodes with and without metastasis.
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Zeming
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zeng
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China. 529716391@qq.com.
authors.forename: Chunping
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Shuntao
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Yiquan
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Yawen
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Shiran
authors.initials: S
authors.lastname: Sun
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.|Department of Breast and Thyroid Surgery, Affiliated Nanshan Hospital, Guangdong Medical University, Shenzhen, China.
authors.forename: Tianwen
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Yusufu
authors.initials: Y
authors.lastname: Maimaiti
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China.
authors.forename: Pan
authors.initials: P
authors.lastname: Yu
authors.affiliation: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, People's Republic of China. huangtaowh@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Huang
mesh_terms: D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy; D014463:Ultrasonography / Q000706:statistics & numerical data*
keywords: Lymph node metastasis; Papillary thyroid microcarcinoma; Ultrasonographic features