背景：颈部淋巴结（LN）转移的存在影响了甲状腺癌的临床分期和预后，但常规B超的作用对LNMs的术前诊断是有限的。淋巴造影增强超声（LCEUS）在甲状腺癌中的诊断价值仍在探索。目的：探讨采用对甲状腺注射造影剂的LCEUS与US相比在检测疑似甲状腺癌的颈部淋巴结转移中的诊断表现。材料和方法：在2020年11月至2021年1月进行了这项单中心前瞻性研究，连续招募了疑似甲状腺癌的参与者，在进行活检之前进行了颈部B超和LCEUS。通过细针穿刺细胞学检查、甲状腺球蛋白冲洗评估或手术后的组织病理学检查证实LNMs。将LCEUS对颈部LN的诊断表现与常规B超进行比较，并评估其与LN大小和位置的关联。结果：最终数据集包括64名参与者（平均年龄45岁±12 [SD]；52名女性）共76个LN。LCEUS对LNM的敏感性、特异性和准确性分别为97％、90％和93％，而常规B超的敏感性、特异性和准确性分别为81％、80％和80％。与US相比，LCEUS对小于1厘米LN（82％ vs 95％；P = .03）和中央颈部LN（VI级）（83％ vs 96％；P = .04）的诊断准确度更高。结论：在术前疑似甲状腺癌中，淋巴造影增强超声比常规B超在检测颈部LN转移的诊断表现更佳，特别是对小于1厘米和中央颈部LN的诊断更佳。©RSNA，2023. 本期编者按见Grant和Kwon的社论。

Background The presence of cervical lymph node (LN) metastases (LNMs) affects clinical staging and prognosis of thyroid cancer, but the role of conventional B-mode US is limited for preoperative diagnosis of LNMs. The diagnostic value of lymphatic contrast-enhanced US (LCEUS) in thyroid cancer is still being explored. Purpose To explore the diagnostic performance of LCEUS by means of thyroidal injection of contrast agent in comparison with US in detecting LNMs of suspected thyroid cancer. Materials and Methods In this single-center prospective study conducted from November 2020 to January 2021, consecutive participants with suspected thyroid cancer underwent B-mode US and LCEUS of cervical LNs before biopsy. LNMs were confirmed with fine-needle aspiration cytologic examination, thyroglobulin washout assessment, or histopathologic examination after surgery. The diagnostic performance of LCEUS for cervical LNs was compared with that of conventional B-mode US, and its association with LN size and location was evaluated. Results The final data set included 64 participants (mean age, 45 years ± 12 [SD]; 52 women) with 76 LNs. The sensitivity, specificity, and accuracy of LCEUS for LNM were 97%, 90%, and 93%, respectively, whereas they were 81%, 80%, and 80%, respectively, for LNM at conventional B-mode US. Compared with US, LCEUS had better diagnostic accuracy for the LNs smaller than 1 cm (82% vs 95%; P = .03) and for central neck LNs (level VI) (83% vs 96%; P = .04). Conclusion Lymphatic contrast-enhanced US had better diagnostic performance than conventional B-mode US for detecting cervical LN metastases in suspected thyroid cancer before surgery, especially for LNs smaller than 1 cm and central neck LNs. © RSNA, 2023 See also the editorial by Grant and Kwon in this issue.