Cervical lymph nodes (LNs) in the central (level VI) and lateral (levels II–V) compartments of the neck are the most common sites of locoregional metastases associated with thyroid cancer. Prophylactic nodal dissections are uncommon in modern thyroid surgery and are not routinely performed due to concern for increased morbidity and do not offer improved survival. Therefore, a selective approach for LN dissections is increasingly important. Preoperatively, this is most frequently assessed with cervical ultrasound (US). Contrast-enhanced computed tomography (CT) of the neck can also be used for preoperative assessment. Both US and CT imaging can be used to characterise LNs in levels II–VI and their risk of malignancy based on size, morphology, and growth. US-guided fine-needle aspiration of equivocal LN with thyroglobulin (Tg) washout can also determine if a LN harbours malignancy. For postoperative surveillance after total thyroidectomy, both US and CT continue to play an important role at 6–12 months intervals. These patients may also benefit from additional biochemical data such as Tg levels in addition to LN and thyroid bed imaging. Thyroid uptake scans may also play a role in LN surveillance postoperatively for well-differentiated thyroid carcinoma in certain clinical contexts. Less commonly, positron emitted tomography may play a role, but is typically reserved for patients with aggressive or radioactive iodine refractory disease.

中文翻译：

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甲状腺癌的淋巴结成像

颈部中央（VI 级）和侧部（II-V 级）区室的颈部淋巴结 (LN) 是与甲状腺癌相关的局部区域转移最常见的部位。预防性淋巴结清扫在现代甲状腺手术中并不常见，并且由于担心发病率增加而未常规进行，并且不能提高生存率。因此，淋巴结解剖的选择性方法越来越重要。术前，最常通过宫颈超声（美国）进行评估。颈部增强计算机断层扫描 (CT) 也可用于术前评估。US 和 CT 成像均可用于表征 II-VI 级淋巴结及其基于大小、形态和生长的恶性风险。在超声引导下对可疑的淋巴结进行细针抽吸并进行甲状腺球蛋白 (Tg) 冲洗也可以确定淋巴结是否存在恶性肿瘤。对于全甲状腺切除术后的术后监测，US 和 CT 继续以 6-12 个月的间隔发挥重要作用。除了 LN 和甲状腺床成像之外，这些患者还可能受益于其他生化数据，例如 Tg 水平。在某些临床情况下，甲状腺摄取扫描也可能在高分化甲状腺癌术后淋巴结监测中发挥作用。不太常见的是，正电子发射断层扫描可能发挥作用，但通常只用于患有侵袭性或放射性碘难治性疾病的患者。