American Journal of Neuroradiology, Vol 19, Issue 3 509-513, Copyright © 1998 by American Society of Neuroradiology
ARTICLES |
Papillary thyroid carcinoma: MR diagnosis of lymph node metastasis
S Takashima, S Sone, F Takayama, Q Wang, T Kobayashi, A Horii and JI Yoshida
Department of Radiology, Shinshu University School of Medicine, Asahi, Matsumoto, Japan.
PURPOSE: The purpose of this study was to ascertain the usefulness of MR imaging in the diagnosis of nodal metastasis of papillary thyroid carcinoma and to establish the most indicative MR criteria of metastasis. METHODS: Pathologic records and MR images in 50 patients with papillary thyroid carcinoma were reviewed. Each neck was divided into four nodal levels, so that 200 nodal levels were assessed in all. The maximum of the minimum transverse diameters of the lymph nodes on each nodal level measured on MR images and the certainty of metastasis as determined by a head and neck radiologist on the basis of morphologic aspects were compared with the pathologic findings by using receiver operating characteristic curves. The presence or absence of cystic nodes on each nodal level was also evaluated. RESULTS: Metastasis was found on 87 (44%) of the nodal levels in 34 (68%) of the patients. A cystic node was identified on 33 (17%) of the nodal levels in 13 (26%) of the patients and was seen only on positive nodal levels. Morphologic diagnosis by the radiologist was better than that obtained by measurement. With the combined criteria of a cystic node or a node of 13 mm or more for the maximum of the minimum transverse diameters, specificity was 100% with an 82% accuracy and always indicated metastasis (100% positive predictive value). However, 41% of the metastatic nodes were missed with this criterion (59% sensitivity). CONCLUSION: MR imaging was useful for diagnosing metastatic nodes; a nodal diameter threshold of 13 mm or the presence of a cystic node strongly indicated metastasis from papillary thyroid carcinoma.
This article has been cited by other articles:
 |
|
 |
|
  N. A. Johnson and M. E. Tublin Postoperative Surveillance of Differentiated Thyroid Carcinoma: Rationale, Techniques, and Controversies Radiology, November 1, 2008; 249(2): 429 - 444. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Takashima, F. Takayama, J. Wang, S. Kobayashi, and M. Kadoya Using MR Imaging to Predict Invasion of the Recurrent Laryngeal Nerve by Thyroid Carcinoma Am. J. Roentgenol., March 1, 2003; 180(3): 837 - 842. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-c. Wang, S. Takashima, F. Takayama, S. Kawakami, A. Saito, T. Matsushita, H. Matsuba, and S. Kobayashi Tracheal Invasion by Thyroid Carcinoma: Prediction Using MR Imaging Am. J. Roentgenol., October 1, 2001; 177(4): 929 - 936. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Q. Wang, S. Takashima, H. Fukuda, F. Takayama, S. Kobayashi, and S. Sone Detection of Medullary Thyroid Carcinoma and Regional Lymph Node Metastases by Magnetic Resonance Imaging Arch Otolaryngol Head Neck Surg, August 1, 1999; 125(8): 842 - 848. [Abstract] [Full Text] [PDF]
|
|