Accuracy of sonographic elastography in the differential diagnosis of enlarged cervical lymph nodes: Comparison with conventional B-mode sonography
Accuracy of sonographic elastography in the differential diagnosis of enlarged cervical lymph nodes: Comparison with conventional B-mode sonography
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DOI：
10.2214/ajr.07.3401
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发表时间：
2008-08-01
影响因子：
5
通讯作者：
Ito, Katsuhide
中科院分区：
文献类型：
--
作者：
Alam, Farzana;Naito, Kumiko;Ito, Katsuhide
OBJECTIVE.本研究的目的是评价超声弹性成像和B超在鉴别反应性和转移性肿大颈部淋巴结中的诊断性能。在这项前瞻性研究中，对37例患者的85个淋巴结（转移性，n = 53;反应性，n = 32）进行了弹性成像和B超检查。根据高弹性（硬）淋巴结区域的分布和百分比确定弹性成像模式，模式1是不存在或非常小的硬区域，模式5是占据整个淋巴结的硬区域。反应性与转移性的截止线设定在模式2和3之间;模式3-5被认为是转移性的。B超诊断基于5个标准的评分总和：短轴直径、形状、边界（规则或不规则）、回声（均匀或不均匀）和肺门（存在或不存在）。反应性与转移性的分界线设定在6分和7分之间; 5分和6分被认为是反应性的，7分-10分被认为是转移性的。B超的敏感性、特异性和准确性分别为98%、59%和84%;弹性成像的敏感性、特异性和准确性分别为83%、100%和89%;联合评估的敏感性、特异性和准确性分别为92%、94%和93%。高特异性弹性成像与高灵敏度常规B超的结合有可能进一步提高对颈淋巴结转移性肿大的诊断。
OBJECTIVE. The purpose of our study was to evaluate the diagnostic performance of sonographic elastography and Bmode sonography individually and combined in the differentiation of reactively and metastatically enlarged cervical lymph nodes.SUBJECTS AND METHODS. Eighty-five lymph nodes (metastatic, n = 53; reactive, n = 32) from 37 patients were examined by both elastography and Bmode sonography in this prospective study. Elastographic patterns were determined on the distribution and percentage of the lymph node area with high elasticity (hard), with pattern 1 being an absent or very small hard area to pattern 5, a hard area occupying the entire lymph node. The cutoff line for reactive versus metastatic was set between patterns 2 and 3; patterns 3-5 were considered metastatic. Bmode sonographic diagnosis was based on the sum of scores for five criteria: short-axis diameter, shape, border (regular or irregular), echogenicity (homogeneous or inhomogeneous), and hilum (present or absent). The cutoff line for reactive versus metastatic was set between scores 6 and 7; scores 5 and 6 were considered reactive, and scores 7-10, metastatic.RESULTS. Sensitivity, specificity, and accuracy of Bmode sonography were 98%, 59%, and 84%, respectively; 83%, 100%, and 89% for elastography; and 92%, 94%, and 93% for the combined evaluation.CONCLUSION. The combination of highly specific elastography with highly sensitive conventional Bmode sonography has the potential to further improve the diagnosis of metastatic enlarged cervical lymph nodes.