The sonographic features of preoperative ultrasonography of metastatic tumors of thyroid cancer confirmed by surgical pathology

Abstract

Abstract. This study aimed to analyze the sonographic features of metastatic tumorsin patients with thyroid cancer that underwent preoperative ultrasonogra-phy. One hundred and three thyroid cancer patients whose metastases were con-firmed by surgical pathology in The First People’s Hospital of Wenling from January 2020 toDecember 2021 were enrolled. All patients received preoperative ultra-soundexaminations, and the sonographic features were analyzed. Ultrasound ex-aminationshowed 83.50% of cervical lymph node metastasis (CLNM), 24.27% of soft tissueinvasion (STI), 3.88% of distant organ metastasis (DOM), 8.74% of CLNM + STI, 0.97% of CLNM + DOM, and 0.97% of CLNM + STI+DOM. Unilateral CLNM accounted for 72.09%, while bilateral CLNM accounted for 27.91%. The mean longdiameter of metastatic lymph nodes was (1.83±0.63) cm, and the mean short di-ameterwas (1.03±0.42) cm. Metastases to zone II, III, IV, V, VI, and VII accounted for 8.14%, 48.84%, 23.26%, 4.65%, 11.63%, and 3.49%, respectively. The L/T ratio of lymph nodes in 65 cases was lower than 2; 45 of 70 solid metastases exhibited solidhyperechoic, 15 multifocal hyperechoic, seven unifocal hyperechoic, and three diffusely distributed solid hyperechoic images. There were 25 patients with STI thatexperienced invasion of the thyroid capsule, ten patients experienced the invasion of the cervical fatty muscles, two patients had invasion of the trachea, and one pa-tienthad invasion of the thyroid cartilage. Of the four patients with DOM, one had parotidmetastasis, one had submandibular metastasis, one had axillary metastasis, and onehad uterine metastasis. The most common metastatic sites of thyroid can-cer arecervical lymph nodes. However, there were also metastases in the soft tissues anddistant organs. The ultrasonography exhibited typical sonographic features. An adequate familiarity with these sonographic features can aid in detecting suspiciousmetastases in time, which is crucial to the clinical diagnosis, treatment, and prog-nosticassessment.