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Background <p>To explore the role of contrast-enhanced ultrasound (CEUS) in preoperative ultrasound-guided fine-needle aspiration (US-FNA) of lateral cervical lymph nodes (LCLN) in patients with papillary thyroid carcinoma (PTC).</p> Methods <p>A total of 112 patients with 164 suspicious LCLN were enrolled into two cohorts based on whether they received CEUS examination before US-FNA. In the conventional cohort, 64 nodules from 42 patients underwent direct US-FNA, while in the CEUS-triage cohort, 100 nodules from 70 patients performed CEUS examination first. Among these, 28 homogeneously-centrifugal enhanced nodules were exempt from FNA, and 72 nodules proceeded to US-FNA. The effectiveness of FNA and the cumulative recurrence rate (CRR) during the follow-up period were compared between the two cohorts. The CEUS characteristics of metastatic LCLN were also summarized.</p> Results <p>There was a significant difference in the rate of US-FNA performed between the CEUS-triage cohort and the conventional cohort (72.0% vs. 100.0%, <i>p</i> &lt; 0.001). The CEUS-triage cohort had a lower uncertainty rate of FNA (6.9% vs. 18.8%, <i>p</i> = 0.04). All patients were followed up for an average of 38.4 months. There was no significant difference in the CRR between the two groups in the entire cohort and the surgical population (all <i>p</i> &gt; 0.05). CEUS of metastatic LCLN in PTC showed centripetal enhancement, hypo-enhancement, heterogeneous enhancement, and perfusion defects (all <i>p</i> &lt; 0.001).</p> Conclusions <p>CEUS may have the potential to serve as a valuable triage tool for US-FNA of suspicious LCLN in PTC patients, potentially reducing unnecessary puncture rates and increasing the overall diagnostic yield of biopsies. Features such as centripetal enhancement, hypo-enhancement, heterogeneous enhancement, and perfusion defects observed on CEUS were more frequently linked to metastatic lymph nodes.</p>

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A pilot study assessing the feasibility of contrast-enhanced ultrasound for triaging fine-needle aspiration in lateral cervical lymph nodes of papillary thyroid carcinoma

  • 期刊论文

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  • 发表日期：

    2026年5月28日

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  • Dai Pan,
  • Yuanbing Xu,
  • Yichao Tao,
  • Fen Huang,
  • Cuiling Li

摘要

Background

To explore the role of contrast-enhanced ultrasound (CEUS) in preoperative ultrasound-guided fine-needle aspiration (US-FNA) of lateral cervical lymph nodes (LCLN) in patients with papillary thyroid carcinoma (PTC).

Methods

A total of 112 patients with 164 suspicious LCLN were enrolled into two cohorts based on whether they received CEUS examination before US-FNA. In the conventional cohort, 64 nodules from 42 patients underwent direct US-FNA, while in the CEUS-triage cohort, 100 nodules from 70 patients performed CEUS examination first. Among these, 28 homogeneously-centrifugal enhanced nodules were exempt from FNA, and 72 nodules proceeded to US-FNA. The effectiveness of FNA and the cumulative recurrence rate (CRR) during the follow-up period were compared between the two cohorts. The CEUS characteristics of metastatic LCLN were also summarized.

Results

There was a significant difference in the rate of US-FNA performed between the CEUS-triage cohort and the conventional cohort (72.0% vs. 100.0%, p < 0.001). The CEUS-triage cohort had a lower uncertainty rate of FNA (6.9% vs. 18.8%, p = 0.04). All patients were followed up for an average of 38.4 months. There was no significant difference in the CRR between the two groups in the entire cohort and the surgical population (all p > 0.05). CEUS of metastatic LCLN in PTC showed centripetal enhancement, hypo-enhancement, heterogeneous enhancement, and perfusion defects (all p < 0.001).

Conclusions

CEUS may have the potential to serve as a valuable triage tool for US-FNA of suspicious LCLN in PTC patients, potentially reducing unnecessary puncture rates and increasing the overall diagnostic yield of biopsies. Features such as centripetal enhancement, hypo-enhancement, heterogeneous enhancement, and perfusion defects observed on CEUS were more frequently linked to metastatic lymph nodes.