Abstract:

Objective To establish a predictive model based on shear wave elastography combined with two ⁃dimensional ultrasound，and to explore its predictive value for central lymph node metastasis in papillary thyroid carcinoma（PTC）. Methods A total of 501 patients with PTC were selected，and the two ⁃dimensional sonographic features and shear wave elastography of the nodules were retrospectively analyzed. Using postoperative pathology as the gold standard ，the patients were divided into central lymph node metastasis group and non⁃ metastatic group. The receiver operating characteristic（ROC）curve was used to analyze the shear wave elasticity measurement to determine the best cut⁃off value for the central lymph node metastasis. Single⁃factor and multi⁃ factor analysis of independent risk factors affecting central lymph node metastasis were used to establish a predictive model. After the model was established，131 papillary thyroid carcinoma nodules were included for verification to evaluate the predictive ability，compared with postoperative pathology. Results Logistic regression analysis showed that the factors that affected the central lymph node metastasis were tumor size，multifocality，capsular infiltration，and Emean value. The ROC curve with the predicted probability value was drawn，and the area under curve of the ROC was 0.908.The verification group was used to verify that the accuracy was 93.1%，the sensitivity was 90.5%，the missed diagnosis rate was 9.5%，the specificity was 93.2%，and the misdiagnosis rate was 6.8%. Conclusion The prediction model based on shear wave elastography combined with two ⁃dimensional ultrasound has a good predictive value for lymph node metastasis in the central area of papillary thyroid carcinoma，which helps to improve the preoperative diagnosis rate of central lymph node metastasis in PTC. To a certain extent，it provides help for the choice of clinical treatment plan.

Key words:

shear wave, elastography, two ? dimensional ultrasound, papillary thyroid carcinoma, central lymph node metastasis