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To investigate the independent risk factors for cervical lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC) and establish a prediction model via conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS).A total of 275 patients with single PTC, who were admitted to our hospital from January 2016 to December 2018, were enrolled in this study. The clinical characteristics and features of the tumor on conventional US and CEUS were retrospectively analyzed. A binary logistic regression model was established, and the diagnostic efficacy of conventional US and CEUS was compared.The binary logistic regression analysis showed that age younger than 38 years, size of 10.0 mm or greater, solid composition, peak of the nodule interior of 28.3750 or greater, and area under the curve (AUC) of the peripheral ring of less than 3.2500 were independent risk factors of CLNM (P .05, for all). Prediction model: Logit (p) = -4.135 + 1.040 (age) + 1.920 (size) + 1.769 (composition) + 1.230 (peak of nodule interior) + 0.812 (AUC of peripheral ring). The model positively predicted CLNM at a value of L -0.199. The AUC, sensitivity, and negative predictive value of the receiver operating characteristic curve for the model were 0.727, 71.7%, and 75.2%, respectively, which were significantly higher than those of conventional US (Z = -2.403; P = .016; Z = -5.330; P .001; and Z = -2.390; P = .017). The specificity of the model was 73.7%, which was lower than that of conventional US (Z = 3.508; P .001).The preoperative prediction model established via conventional US and CEUS may be helpful to evaluate CLNM in patients with PTC and determine the appropriate treatment options.

Purpose: To investigate the clinical and ultrasonographic features of papillary thyroid carcinoma (PTC) in the isthmus.Methods: A total of 823 patients with 823 PTCs including 133 in the isthmus and 690 in the lateral lobe were included in our study. All patients were confirmed by post-operative pathology. The clinical and ultrasonographic characteristics were retrospectively analyzed and compared. Univariate analysis and multivariate logistic regression analysis were performed.Results: Multi-factor analyses showed that PTC in the isthmus was significantly different from PTC originating from the lateral lobe in aspect ratio, microcalcification, extrathyroid extension, lymph node metastasis（LNM）, lymph node density（LND） (P < 0.05, for all). There were no significant differences in age, gender, tumor size, margin, halo, echogenicity and homogeneity (P > 0.05, for all).Conclusions: The sonographic appearance of PTC in the isthmus was not typical, however, it had a higher incidence of extrathyroidal extension, central lymph node involvement and a tendency of higher lymph node density. Therefore, more careful ultrasound evaluation should be performed for these nodules.