A COMPARATIVE STUDY BETWEEN B-MODE WITH COLOR DOPPLER SONOGRAPHY AND ELASTOGRAPHY IN DIFFERENTIATING BENIGN AND MALIGNANT CERVICAL LYMPHADENOPATHY

Abstract

Objectives- The purpose of this study was to determine the usefulness of ultrasound elastography in the evaluation of enlarged cervical lymph nodes in comparison with B-mode and color Doppler sonography. Methods-A total of 230 lymph nodes in 164 consecutive patients referred for sonography of the neck were included. B-mode sonograms were evaluated according to short-axis diameter, long-to-short-axis ratio, hilum, echogenicity, and microcalcication. Five different patterns were dened according to vascularity for color doppler sonography. Elastography patterns of the lymph nodes were categorized to 5 main types. The strain index values were calculated for all lymph nodes. Histopathologic ndings were used as reference standards for the diagnosis of benign and malignant lymph nodes. Results-Of the 230 lymph nodes, 62.6% were diagnosed as benign, and 37.4% were diagnosed as malignant. The sensitivity, specicity, and accuracy of B-mode sonography with color Doppler were 76.7%, 81.9%, and 80.0%, respectively; the values were 82.6%, 56.6%, and 66.9% for strain elastography sonography. The strain index cutoff value for the differentiation of benign and malignant lymph nodes was accepted as 1.7. Conclusions-Combination of B-mode sonographic features and vascular pattern of the lymph nodes is best imaging modality in differentiating between malignant and benign cervical lymphadenopathy. Ultrasound elastography adds no additional value to combined B- mode and color Doppler sonography for differentiation of benign and malignant cervical lymph nodes.