Objective To explore the evaluation value of contrast-enhanced ultrasound through lymphatic vessel (LCEUS) and ultrasonic shear wave elastography (SWE) in central compartment lymph node metastasis of thyroid carcinoma (TC). Methods A total of 70 patients with TC confirmed in the hospital were enrolled between February 2020 and February 2023. According to presence or absence of lymph node metastasis

they were divided into metastasis group (n=30) and non-metastasis group (n=40). All underwent LCEUS and SWE. LCEUS parameters (perfusion order

perfusion mode

arrival time

time to peak

peak intensity) and SWE parameters [the maximum Young modulus (Emax)

the minimum Young modulus (Emin)

mean Young modulus (Emean)] were compared. The diagnostic efficiency of LCEUS and SWE for central compartment lymph node metastasis of TC was analyzed by receiver operating characteristic (ROC) curves. Results There were significant differences in LCEUS parameters (perfusion order

perfusion mode

arrival time

time to peak

peak intensity) between metastasis group and non-metastasis group (P<0.05). SWE parameters (Emax

Emin

Emean) in metastasis group were higher than those in non-metastasis group (P<0.05). ROC curves analysis showed that AUC

sensitivity and specificity of arrival time

time to peak

peak intensity

Emax

Emin

Emean and combined detection in the diagnosis of central compartment lymph node metastasis were (0.582

0.698

0.771

0.861

0.660

0.757

0.764)

(70.00%

66.70%

76.70%

86.70%

76.70%

78.00%

90.00%) and (40.00%

62.50%

67.50%

85.00%

60.00%

62.50%

57.50%)

respectively. Conclusion LCEUS combined with SWE has high sensitivity and clinical value in the diagnosis of central compartment lymph node metastasis of TC.