Evaluation of the role of sono-elastography in diagnosis of enlarged cervical lymph nodes

Abstract

Purpose: Evaluation of the role of real-time elastography in differentiating between benign and malignant cervical lymph nodes (LNs), comparison with B-mode and Doppler Ultrasonography. Patients and methods: This prospective study included 30 patients, with cervical lymphadenopathy, their age ranged from (18–79 years). The total number of the examined lymph nodes (LNs) was 75 LNs. These (LNs) subjected to B-mode US followed by Doppler evaluation, then elastographic evaluation including strain ratio which was calculated for each lesion, and compared with the histological results after fine needle aspiration cytology. Results: We evaluate the size, shape, echogenicity, and hilum on the B-mode images. The presence of the hilum showed the highest accuracy & sensitivity. Doppler Ultrasonography evaluation of nodal vascular pattern was of high sensitivity & specificity. The calculated sensitivity of elastographic pattern and scoring was 86%, specificity was 100%, PPV and NPV were 100% and 78.1% respectively, and the total accuracy was 90%. The mean elastographic strain ratio for malignant LNs (3.4 ± 1.2) was significantly greater than that for benign LNs (mean, 1.2 ± 0.3). Conclusion: Elastography is a promising improvement for differentiation between benign and malignant cervical lymphadenopathy. Sensitivity and specificity of elastography increased especially if combined with gray scale US and Doppler US.

Keywords

• Elastography
• Cervical lymph nodes
• Doppler US
• Neck
• Ultrasound