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Value of Ultrasound Elastography in the Differential Diagnosis of Cervical Lymph Nodes
Author(s) -
Acu Leyla,
Oktar Suna Özhan,
Acu Rusen,
Yücel Cem,
Cebeci Süleyman
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.09019
Subject(s) - medicine , elastography , radiology , differential diagnosis , cervical lymph nodes , ultrasound , lymph , ultrasonography , ultrasound elastography , pathology , metastasis , cancer
Objectives The purpose of this study was to determine the usefulness of ultrasound elastography in the evaluation of enlarged cervical lymph nodes in comparison with B‐mode and color Doppler sonography. Methods A total of 220 lymph nodes in 168 consecutive patients who were referred for sonography of the neck were included in this study. B‐mode sonograms were evaluated according to short‐axis diameter, long‐to‐short‐axis ratio, hilum, echogenicity, and microcalcification. For color Doppler sonography, 5 different patterns were defined according to vascularity. Elastographic patterns of the lesions were categorized to 5 main types. The mean strain index values were calculated for all lymph nodes. Histopathologic findings, clinical and laboratory data, and imaging findings were used as reference standards for the diagnosis of benign and malignant lymph nodes. Results Of the 220 lymph nodes, 69.5% were diagnosed as benign, and 30.5% were diagnosed as malignant. The sensitivity, specificity, and accuracy of B‐mode sonography were 97.0%, 31.4%, and 51.3%, respectively; the values were 76.1%, 82.4%, and 80.5% for color Doppler sonography and 82.1%, 56.2%, and 64.1% for elastography. The strain index cutoff value for the differentiation of benign and malignant lymph nodes was accepted as 1.7. The sensitivity, specificity, and accuracy of the strain index were 71.6%, 76.5%, and 75.0%. Conclusions Ultrasound elastography adds no additional value to combined B‐mode and color Doppler sonography for differentiation of benign and malignant cervical lymph nodes.