Ultrasound elastography in pathological enlarged cervical lymph nodes compared to histopathology

Abstract

Objective: To detect the diagnostic efficiency of ultrasound elastography in differentiation between benign and malignant enlarged cervical lymph nodes. Patient and methods: This study included 27 patients, ranging in age from 21 to 70 years. Enlarged cervical lymph nodes were defined in this study as those nodes having short axis measuring more than 8 mm. Approval was taken from our hospital institutional review board and an informed consent was obtained from each patient before participating in the study. All patients were subjected to B-mode ultrasound and ultrasound elastography. Results: B-mode score had the highest sensitivity in this study (sensitivity = 100%) and the least specificity and positive predictive value. Ultrasound Elastography (UE) and strain ration (SR) showed higher specificity (75%) and PPV (81.3% and 82.4% respectively). There was a statistical significant difference between the diagnostic performance of ES and B-mode score (p = 0.034), and a nearly significant difference between SR and B-mode score (p = 0.059). ROC curve analysis for SR measurements (cutoff value ⩾1.62) showed sensitivity = 93.3%, specificity = 75% and overall accuracy = 85.2%. However, no statistically significant difference was shown between the performance of ES and SR (p = 0.317). Conclusion: Hardness on more than 50% of the node surface and SR > 1.62 are fair to good indicators of malignancy.

Keywords

• Ultrasound elastography
• Enlarged cervical lymph node
• Strain ratio