Application of Real-Time Ultrasound Elastography and Conventional B-Mode Ultrasonography in Diagnosis of Thyroid Carcinoma Metastatic Cervical Lymph Nodes
ZHENG Xuan, CHEN Song-wang
Department of Function, The First Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu 210000, China
Abstract：Objective To discuss the effectiveness of application of real-time ultrasound elastography and conventional B-mode ultrasonography in diagnosis of thyroid carcinoma metastatic cervical lymph nodes. Methods In this retrospective study, 56 patients with thyroid carcinoma were examined by both conventional B-mode ultrasonography and real-time ultrasound elastography. B-Mode sonographic diagnosis was based on the total scores of five criteria in order to identify lymph node metastases. In real-time ultrasound elastography, two methods were used to assess the lymph nodes, including the RTE4 method and EXL measurement. The the critical value of the EXL was calculated through the ROC (Receiver Operating Characteristic) curve. The combination of real-time ultrasound elastography and conventional B-mode ultrasonography was also used to diagnose the thyroid carcinoma metastatic cervical lymph nodes. Comparisons were made between the diagnostic results and postoperatively pathological results. Results Sensitivity, specificity and accuracy of conventional B-mode ultrasonography were 76%, 90% and 82% respectively in comparison with elastography’s 89%, 75%, 83% and the combination diagnosis method’s 96%, 88%, 92%. The best critical value of EXL2/1 was 2.17. Sensitivity and specificity were both 88%. The area under the ROC was 0.91. Conclusion Combination of application of conventional B-mode ultrasonography and ultrasound elastography could improve the diagnosis of thyroid carcinoma metastatic cervical lymph nodes.
Ahuja A,Ying M.Sonography of neck lymph nodes.Part2:abnormal lymph nodes[J].Clin Radiol,2003,58(5):359-366.
[8]
Ying M,Bhatia KS,Lee YP,et al.Review of ultrasonography of malignant neck nodes:greyscale, Doppler, contrast enhancement and elastography[J].Cancer Imaging,2014,13(4):658-669.
[5]
Alam F,Naito K,Horiguchi J,et al.Accuracy of sonographic elastography in the differential diagnosis of enlarged cervical lymph nodes:comparison with conventional B-mode sonography[J].AJR Am J Roentgenol,2008,191(2):604-610.
Teng DK,Wang H,Lin YQ,et al.Value of ultrasound elastography in assessment of enlarged cervical lymph nodes[J].Asian Pac J Cancer Prev,2012,13(5):2081-2085.
[13]
Dudea SM,Botar-Jid C,Dumitriu D,et al.Differentiating benign from malignant superficial lymph nodes with sonoelastography[J].Med Ultrason,2013,15(2):132-139.
[3]
Castelijns JA,van den Brekel MW.Imaging of lymphadenopathy in the neck[J].Eur Radiol,2002,12(4):727-738.
[2]
Teng DK,Wang H,Lin YQ,et al.Value of ultrasound elastography in assessment of enlarged cervical lymph nodes[J].Asian Pac J Cancer Prev,2012,13(5):2081-2085.
[10]
Ishibashi N,Yamagata K,Sasaki H,et al.Real-time tissue elastography for the diagnosis of lymph node metastasis in oral squamous cell carcinoma[J].Ultrasound Med Biol,2012,38(12): 389-395.
[9]
Bhatia KS,Cho CC,Yuen YH,et al.Real-time qualitative ultrasound elastography of cervical lymph nodes in routie clinical practice: interobserver agreement and correlation with malignancy[J].Ultrasound Med Biol,2010,36(12):1990-1997.
[12]
Ying L,Hou Y,Zheng HM,et al.Real-time elastography for the differentiation of benign and malignant superficial lymph nodes:a meta-analysis[J].Eur J Radiol,2012,81(10):2576-2584.
[1]
Iagnocco A,Kaloudi O,Perella C,et al.Ultrasound elastography assessment of skin involvement in systemic sclerosis:lights and shadows[J].J Rheumatol,2010,37(8):1688-1691.
[4]
Wu CH,Hsu MM,Chang YL,et al.Vascular pathology of malignant cervical lymphadenopathy:qualitative and quantitative assessment with power Doppler ultrasound[J].Cancer,1998,83(6):1189-1196.
[15]
Choi JJ,Kang BJ,Kim SH,et al.Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer[J].J Ultrasound Med,2011,30(4):429-436.
[14]
Wojcinski S,Dupont J,Schmidt W,et al.Real-time ultrasound elastography in 180 axillary lymph nodes:elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases[J].BMC Med Imaging,2012,12:35.
