Accuracy of Sonographic Elastography in the Differential Diagnosis of Enlarged Cervical Lymph Nodes: Comparison with Conventional B-Mode Sonography  

Oleh:

Alam, Farzana ; Naito, Kumiko ; Horiguchi, Jun ; Fukuda, Hiroshi

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: American Journal of Roentgenology vol. 191 no. 02 (Aug. 2008), page 604-610 .
Topik: Head and Neck Imaging; Elastography; lymph nodes; metastasis; sonography

Ketersediaan

Perpustakaan FK Nomor Panggil: A13.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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OBJECTIVE. The purpose of our study was to evaluate the diagnostic performance of sonographic elastography and B-mode 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 B-mode 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. B-mode 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 B-mode 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 B-mode sonography has the potential to further improve the diagnosis of metastatic enlarged cervical lymph nodes.

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