Diagnosis Of Cervical Lymph Nodes Research Articles

A study on the correlation of Doppler ultrasound in the diagnosis of cervical lymph nodes in patients with laryngeal and hypopharyngeal cancers: An observational study.

The objective was to assess the diagnostic efficacy of Doppler ultrasound in detecting cervical lymph nodes in patients diagnosed with laryngeal and hypopharyngeal cancers. Patients undergoing surgery for laryngeal and hypopharyngeal cancers in the Otolaryngology Department from January 2021 to January 2023 were included. Two groups, with equal numbers, underwent ultrasound examination and intensive CT examination in the experimental and control groups, respectively, along with routine cervical lymph node dissection. A resident with over 6 years of clinical experience in the otolaryngology department performed routine bilateral cervical lymph node palpation. Sensitivity, specificity, and validity were compared among different examination methods. The McNemar test assessed specificity and sensitivity between palpation, color Doppler ultrasonography, and enhanced CT, while the Kappa concordance test evaluated the concordance between the 2 examination methods. Data were statistically analyzed using SPSS 23.0. Palpation showed a diagnostic sensitivity (DS) of 52.83% and specificity of 91.11% for all patients with cervical lymph node metastasis. Ultrasonography demonstrated a DS of 77.78% and specificity of 81.82% in patients with cervical lymph node metastasis, while intensive CT had a DS of 75.86% and specificity of 60.00%. Statistical significance (P < .05) was observed in the sensitivity between palpation and ultrasonography, and between palpation and enhanced CT. The specificity between enhanced CT and ultrasonography (P = .021) and between palpation and enhanced CT scan (P = .003) both showed statistical significance (P < .05). Doppler ultrasound yields diagnostic results highly consistent with pathological diagnoses in patients with laryngeal and hypopharyngeal cancers. Utilizing Doppler ultrasound can enhance the accuracy of diagnosing these cancers, aiding physicians in devising more suitable treatment plans for patients.

Iodine density of lymphoma, metastatic SCCA, and normal cervical lymph nodes: Based on DLSCT

Objective To compare iodine density (ID) and contrast-enhanced attenuation value (CEAV) from dual-layer spectral computed tomography (DLSCT) scans of lymphomatous, metastatic squamous cell carcinoma (SCCA), and normal cervical lymph nodes. Methods Data including ID and CEAV were retrospectively collected from patients who underwent DLSCT of the neck between January 2020 and August 2023. Results from each group (lymphomatous, metastatic SCCA, and normal) were compared and analyzed using one-way ANOVA and receiver operating characteristic curve. Results 129 cervical lymph nodes were collected from patients who met the inclusion criteria (50, 41, and 38 nodes from the lymphomatous, metastatic SCCA, and normal group, respectively). The mean ID of lymphomatous, metastatic SCCA, and normal nodes was 1.01±0.27, 1.36±0.28, and 1.45±0.29 mg/mL, respectively. Comparing lymphomatous nodes with metastatic SCCA nodes, the lymphomatous nodes had significantly lower values of ID (p&lt;0.002) and CEAV (p&lt;0.001). Similarly, when comparing lymphomatous nodes with normal nodes, the lymphomatous nodes had significantly lower values of ID (p&lt;0.001) and CEAV (p&lt;0.001). The optimal ID cut-off value for distinguishing between lymphomatous and metastatic SCCA nodes was 1.175 mg/ml (specificity of 84.2%, sensitivity 77.8%, AUC 0.788, P = 0.003). The optimal CEAV cut-off value was 77.5 HU (specificity 88.9%, sensitivity 78.9%, AUC 0.851, P&lt;0.001). Conclusions The ID and CEAV measurements from DLSCT were significantly different between lymphomatous, metastatic SCCA, and normal lymph nodes. These findings indicate that DLSCT can be used to distinguish between these conditions in the diagnosis of cervical lymph nodes.

Advances in the application of contrast-enhanced ultrasound in the differential diagnosis of benign and malignant cervical lymph nodes

The accurate diagnosis and differential diagnosis of cervical lymph node lesions are very important for making scientific diagnosis and treatment strategy and evaluating the prognosis of the disease. Contrast-enhanced ultrasound (CEUS) can continuously observe the microcirculation and blood flow perfusion of lymph nodes, and significantly improve the accuracy of diagnosis of cervical lymph nodes, it has been gradually applied to localize the sentinel lymph node, guide biopsy, evaluate the treatment effect of lymph node and molecular imaging. This article reviews the recent advances in the application of CEUS in the diagnosis of benign and malignant cervical lymph nodes.

Computer-aided diagnostic models to classify lymph node metastasis and lymphoma involvement in enlarged cervical lymph nodes using PET/CT.

It is a clinical problem to identify histological component in enlarged cervical lymph nodes, particularly in differentiation between lymph node metastasis and lymphoma involvement. To construct two kinds of deep learning (DL)-based computer-aided diagnosis (CAD) systems including DL-convolutional neural networks (DL-CNN) and DL-machine learning for pathological diagnosis of cervical lymph nodes by positron emission tomography (PET)/computed tomography (CT) images. We collected CT, PET, and PET/CT images series from 165 patients with enlarged cervical lymph nodes receiving examinations from January 2014 to June 2018. Six CNNs pretrained on ImageNet as DL architectures were used for two kinds of DL-based CAD models, including DL-CNN and DL-machine learning models. The DL-CNN models were constructed via transfer learning for classification of lymphomatous and metastatic lymph nodes. The DL-machine learning models were developed by DL-based features extractors and support vector machine (SVM) classifier. As for DL-SVM models, we also evaluate the effect of handcrafted radiomics features in combination of DL-based features. The DL-CNN model with ResNet50 architecture on PET/CT images had the best diagnostic performance among all six algorithms with an area under the receiver operating characteristic curve (AUC) of 0.845 and accuracy of 78.13% in the testing cohort. The DL-SVM model on ResNet50 extractor showed great performance for the testing cohort with an AUC of 0.901, accuracy of 86.96%, sensitivity of 76.09%, and specificity of 94.20%. The combination of DL-based and handcrafted features yielded the improvement of diagnostic performance. Our DL-based CAD systems on PET/CT images were developed for classifying metastatic and lymphomatous involvement with favorable diagnostic performance in enlarged cervical lymph nodes. Further clinical practice of our systems may improve quality of the following therapeutic interventions and optimize patients' outcomes.

The influence of thyroid status, serum Tg, TSH, and TgAb on FNA-Tg in cervical metastatic lymph nodes of papillary thyroid carcinoma.

ObjectivePapillary thyroid carcinoma is treated in China mostly with surgery, including total ablation, lobectomy, and lobe and isthmus resection. Therefore, whether thyroid status affects the FNA‐Tg cutoff value in the diagnosis of cervical lymph node metastasis deserves our attention. In addition, we investigated the influence of serum Tg, TSH, and TgAb on the accuracy of using FNA‐Tg for diagnosis.MethodsOur retrospective analysis included 189 suspected cervical lymph nodes, and we determined whether the cutoff value of FNA‐Tg was affected by thyroid status, sTg, sTSH, and sTgAb.ResultsIn thyroid present cases, the optimal cutoff value of FNA‐Tg was 2.3 ng/ml (sensitivity 96.2%, specificity 100%), and in the thyroid absent cases, the optimal cutoff value of FNA‐Tg was 0.7 ng/ml (sensitivity 97.6%, specificity 96.0%). Although serum Tg, TSH, and TgAb were weakly correlated with FNA‐Tg values, they did not affect the diagnostic performance of the optimal cutoff value of FNA‐Tg according to thyroid status.ConclusionsThe optimal cutoff value of FNA‐Tg should be selected according to the thyroid status (2.3 ng/ml for thyroid present cases and 0.7 ng/ml for thyroid absent cases) to ensure the efficient diagnosis of cervical metastatic lymph nodes of papillary thyroid carcinoma. It was determined that sTg, sTSH, and sTg‐Ab cannot influence the diagnostic performance of FNA‐Tg. The combination method of FNA‐Tg and FNAC is the most optimal choice for the diagnosis of lymph nodes metastasis.

The value of contrast-enhanced ultrasound for the diagnosis of metastatic cervical lymph nodes of papillary thyroid carcinoma: A systematic review and meta-analysis.

To investigate the diagnostic efficiency of contrast-enhanced ultrasound (CEUS) for the diagnosis of cervical lymph nodes metastasis (CLNM) of papillary thyroid carcinoma (PTC), eight available datasets of seven qualified articles before March 31, 2021 were included after a comprehensive search. Meta-analysis results showed that CEUS demonstrated acceptable diagnostic performance in the diagnosis of CLNM of PTC. Furthermore, meta-regression analysis was conducted to identify the reasons for heterogeneity and the results indicated that the criteria of CEUS for the diagnosis of CLNM in PTC need to be unified.

Computer aided diagnosis system for cervical lymph nodes in CT images using deep learning

Background and objectiveEfficient treatment of head and neck cancer requires fast and reliable detection and diagnosis of cervical lymph nodes (CLNs). In current practices, manual methods for detection and invasive onco-pathological tests for diagnosis are considered as the gold standards. These methods suffers from numerous shortcomings which makes them inefficient. This raises the need of a non-invasive and automated computer aided diagnosis (CADx) system. Such CADx system undermines the data for extracting the discriminant information and computed tomography (CT) images are information rich and non-invasive imaging modality for oncological diseases. The design of reliable CADx system demands both accurate detection and classification of CLNs in CT images. MethodsThe authors have proposed the deep learning based innovative and customized architecture based on attention mechanism and residual concept with the base UNet model, for the CLNs detection part (LNdtnNet) of the CADx system. While another architecture based on squeeze and excitation network and residual network with the base model of modified VGG, is proposed for the remaining diagnosis part (LNdgsNet) of the proposed CADx System. ResultsIn first stage, the proposed LNdtnNet for CLNs detection found the best results of sensitivity = 92.78%, and Dice score = 94.18%. In second stage, proposed LNdgsNet attaining an average sensitivity, specificity, accuracy, and area under the curve of 95.62%, 93.88%, 95.28%, and 94.75%, respectively. ConclusionThe proposed both architectures trained offline run on a single platform back to back for testing cases. The overall results confirm the utility of the proposed CADx system.

The Utility of Ultrasonography in the Diagnosis of Cervical Lymph Nodes after Chemoradiotherapy for Head and Neck Squamous Cell Carcinoma.

Background and Objectives: There is evidence or consensus on the use of 18F-2-fluorodeoxyglucose-positron emission tomography with computed tomography (PET-CT) in evaluating the effects of treatment at 12 weeks after chemoradiotherapy for head and neck squamous cell carcinoma with cervical lymph node metastasis. However, the use of imaging to evaluate the effects of treatment within 12 weeks after chemoradiotherapy is controversial. The aim of this study was to evaluate the usefulness of ultrasonography in the diagnosis of lymph nodes metastasis after chemoradiotherapy according to the criteria of the “Evaluation of the effects of treatment on metastatic cervical lymph nodes using ultrasonography”, which evaluated lymph nodes metastasis based on size change and presence of degeneration. Materials and methods: This prospective study included 34 head and neck squamous cell carcinoma patients with cervical lymph nodes metastasis. Thirty-two patients who completed treatment were analyzed. Ultrasonography was performed at 4 and 8 weeks after chemoradiotherapy and we judged whether a favorable prognosis could be expected or whether additional treatments should be considered. Ultrasonography and PET-CT were performed at 12 weeks after chemoradiotherapy. Neck dissection was performed if residual disease was suspected based on the PET-CT findings. Results: The accuracy and negative predictive value of ultrasonography were 81.3% and 96.3%, respectively. According to the Ultrasonography findings, the size of lymph nodes metastasis after chemoradiotherapy was significantly smaller than those before chemoradiotherapy (p < 0.05). The fluid and blood flow of lymph nodes metastasis showed a significantly reduced at 12 weeks after chemoradiotherapy (p < 0.05, p < 0.05, respectively). The echo density significantly changed from low to high echoic density after chemoradiotherapy (p < 0.05). Conclusions: Ultrasonography was useful for evaluating cervical lymph nodes metastasis after chemoradiotherapy for head and neck squamous cell carcinoma.

Evaluation of cervical lymph nodes by ultrasound and its correlation with FNAC

Background: The cervical/neck region has a rich network of strategically placed lymph nodes. These nodes can be involved in various diseases. Ultrasound examination of these nodes can yield useful information about the underlying pathologic processes. Aim of The Study: Evaluation of cervical lymph nodes by ultrasound and its correlation with FNAC. Materials and Methods: This was a prospective study done in the department of Radiodiagnosis at Mamata Academy of Medical Sciences, Bachupally, Hyderabad, Telangana, over a period of eight months. A total of 110 cases were studied. First ultrasound examination of the neck nodes was done followed by fine needle aspiration study. The borders of the nodes, echotexture, capsular and hilar vascularity were noted. The findings of the two modalities were correlated. Results: A total of 110 cases were studied with age ranging from 10 years to 70 years. The male to female ratio was 0.2:1. Most (77.2%) cases were diagnosed as reactive lymph nodes on ultrasound. Most of the reactive lymph nodes (70/85) had homogenous echotexture. Most of the reactive lymph nodes (65/85) had hilar vascularity whereas most of the malignant nodes (8/10) showed absence of hilar vascularity. There was good correlation between the ultrasound and FNAC diagnosis of cervical lymph nodes. Conclusion: Cervical lymphadenopathy is more common in the third to fifth decades of life. Reactive enlargement is more common than other etiologies. USG of cervical lymph nodes is a simple, noninvasive diagnostic technique useful for initial evaluation of the nodes and gives clues towards the possible etiology of the lymphadenopathy. For suspicious cases, an FNAC can be done and if the results are equivocal then biopsy procedure can be done for definite diagnosis.

Diagnostic test for detection of cervical lymph node metastasis from oral squamous cell carcinoma via infrared thermal imaging

Objective To evaluate the diagnostic performance of a non-invasive, non-radiating, economical and convenient infrared thermal imaging in the detection of oral squamous cell carcinoma (OSCC) cervical lymph node metastasis, and evaluate its applicability via parallel test and series test. Methods This study was a prospective clinical study which passed the ethical review by the Biomedical Ethics Committee, Hospital of Stomatology, Peking University, and had been submitted for clinical trial registration. Totally 74 OSCC patients who were to undergo a neck dissection were included in this study. The inclusion criteria were patients who: (1) were pathologically diagnosed as malignant tumors and planned to undergo surgical treatment including neck dissection; (2) agreed to participate in this study. The exclusion criteria were those who: (1) had undergone surgeries at head and neck previously; (2) with a history of systemic tumor adjuvant therapies such as radiotherapy or chemotherapy etc; (3) were unwilling or unable to cooperate. Basal information as well as clinical examination results were collected, such as physical examination and contradictive enhanced CT. Besides, infrared thermal imaging was done ahead of surgery. Analysis of the diagnostic power of infrared thermal imaging followed the principles of diagnostic test. The positive signs of infrared thermal imaging were: (1) asymmetric thermographic pattern including vascular pattern in ROI; (2) thickening image of unilateral facial artery/vein, submental artery/vein or external carotid artery; (3) surface temperature of ROI raised over 1 °C compared with the opposite side; (4) changes of neck profile with abnormal temperature pattern. The gold standard of this diagnostic test was pathology diagnosis of cervical lymph nodes. Results The sensitivity of infrared thermal imaging was 75.0%, while the specificity was 69.0%, accuracy was 71.6%, positive predictive value was 64.9% and negative predictive value was 78.4%. The sensitivity of parallel test which stood for the combination of infrared thermal imaging and conventional clinical examinations was 87.9% while the specificity of series test was 97.6%. Conclusion Infrared thermal imaging is a promising non-invasive, non-radiating and economical tool in the detection of cervical lymph node metastasis from OSCC when combined with conventional pre-operative examination.

Tissue characterization using backscatter and attenuation coefficients: theoretical developments and in vivo applications

Conventional echographic imaging depicts anatomical structure by displaying the magnitude of backscattered ultrasound echoes. However, ultrasonic radiofrequency data contains a richer information content that can be exploited for constructing images of intrinsic tissue properties. In particular, spectral-based ultrasonic tissue characterization techniques allow imaging parameters such as the backscatter (BSC) and attenuation (AC) coefficients. Even though this type of analysis has been explored for decades, several challenges ranging from technical algorithmic issues to the lack of widely validated, successful clinical applications have limited efforts directed towards these imaging modalities. The formulation of BSC and AC estimation as a 2-D inverse problem in combination with regularization methods is discussed, and this approach is shown to significantly extend the trade-off between estimation precision and spatial resolution. Recent applications of BSC and AC estimation in vivo are also discussed, including the assessment of interstitial fibrosis and tubular atrophy (IFTA) and inflammation in renal allografts, the diagnosis of cervical lymph nodes, and the high frequency characterization of skin.Conventional echographic imaging depicts anatomical structure by displaying the magnitude of backscattered ultrasound echoes. However, ultrasonic radiofrequency data contains a richer information content that can be exploited for constructing images of intrinsic tissue properties. In particular, spectral-based ultrasonic tissue characterization techniques allow imaging parameters such as the backscatter (BSC) and attenuation (AC) coefficients. Even though this type of analysis has been explored for decades, several challenges ranging from technical algorithmic issues to the lack of widely validated, successful clinical applications have limited efforts directed towards these imaging modalities. The formulation of BSC and AC estimation as a 2-D inverse problem in combination with regularization methods is discussed, and this approach is shown to significantly extend the trade-off between estimation precision and spatial resolution. Recent applications of BSC and AC estimation in vivo are also discussed, in...

The Clinical Value of New Scoring System of Cervical Lymph Node.

To distinguish malignant cervical lymphadenopathy, we established a new scoring system based on ultrasound features. Two hundred sixty-three patients with cervical lymphadenopathy received ultrasonic examination and underwent ultrasound-guided core needle biopsy or fine needle aspiration. The scoring system was proposed by multivariate logistic regression analysis and compared with Liao scoring system (0.06 × age + 4.76 × shortest-to-longest axis ratio + 2.15 × internal echo + 1.80 × vascular pattern). A new scoring system model, 1.346 × margin + 1.339 × hilum + 2.411 × calcification + 2.619 × vascular pattern + 0.837 × shortest-to-longest axis ratio, was generated. Lymph nodes were regarded as malignancy when the score was ≥2.4. Compared with the Liao scoring system, the new scoring system had larger area under the curve (0.86 versus 0.76, P = 0.036), specificity (86.7% versus 75.0%, P = 0.001), accuracy (87.1% versus 80.6%, P = 0.007), and positive predictive value (89.0% versus 80.0%, P = 0.043). Sensitivity (87.4% versus 85.3%, P = 0.647) and negative predictive value (85.0% versus 81.0%, P = 0.395) did not differ. We concluded that the new scoring system is more reliable and can play an important role in the differential diagnosis of cervical lymph nodes.

Contrast-enhanced computed tomography image assessment of cervical lymph node metastasis in patients with oral cancer by using a deep learning system of artificial intelligence

Although the deep learning system has been applied to interpretation of medical images, its application to the diagnosis of cervical lymph nodes in patients with oral cancer has not yet been reported. The purpose of this study was to evaluate the performance of deep learning image classification for diagnosis of lymph node metastasis. The imaging data used for evaluation consisted of computed tomography (CT) images of 127 histologically proven positive cervical lymph nodes and 314 histologically proven negative lymph nodes from 45 patients with oral squamous cell carcinoma. The performance of a deep learning image classification system for the diagnosis of lymph node metastasis on CT images was compared with the diagnostic interpretations of 2 experienced radiologists by using the Mann-Whitney U test and χ2 analysis. The performance of the deep learning image classification system resulted in accuracy of 78.2%, sensitivity of 75.4%, specificity of 81.0%, positive predictive value of 79.9%, negative predictive value of 77.1%, and area under the receiver operating characteristic curve of 0.80. These values were not significantly different from those found by the radiologists. The deep learning system yielded diagnostic results similar to those of the radiologists, which suggests that this system may be valuable for diagnostic support.

Fine needle non-aspiration cytology for the diagnosis of cervical lymph node tuberculosis: a single center experience

IntroductionThe fine-needle cytology is being used as a first line of investigation in the diagnosis of head and neck swellings, as it is simple, cost effective and less invasive as compared to biopsy. ObjectiveThe aims of this study were to evaluate the results of the fine-needle non-aspiration cytology of cervical lymphadenopathy and to study the factors influencing the rate of non-diagnosis results. MethodsThis retrospective study was conducted on selected patients with cervical lymphadenopathy that had undergone a fine-needle non-aspiration cytology followed by a histological biopsy. The sensitivity, specificity, positive predictive value and negative predictive value of fine-needle non-aspiration cytology for diagnosing tuberculosis were estimated. The risk factors of non-diagnosis results were evaluated. ResultsThe sensitivity, specificity, positive predictive value rates of fine-needle non-aspiration cytology for tuberculosis were 83.3%, 83.3%, 78.9% and 86.9% respectively. In total, 47 out of the 131 samples (35.8%) were considered non-diagnosis. Of the non-diagnosis samples, 84.2% (38 out of 47) were benign mostly due to tuberculosis (30 cases). Among the studied factors, only tuberculosis (confirmed by histopathological examination) was significantly associated with non-diagnosis cytology (p=0.02, Odds-Ratio=2.35). ConclusionTuberculosis is currently the commonest cause of cervical lymphadenopathy in North Africa. Fine-needle non-aspiration cytology is safe and accurate in the diagnosis of cervical tuberculous lymph node that is associated with the risk of non-diagnosis cytology.

Preliminary Evaluation of Virtual Touch Tissue Imaging Quantification for Differential Diagnosis of Metastatic and Nonmetastatic Cervical Lymph Nodes.

Virtual Touch tissue imaging quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA) is useful for assessing tissue hardness. This study aimed to investigate the value of VTIQ in differential diagnosis of cervical lymph nodes. We retrospectively analyzed conventional sonograms and VTIQ images of 85 pathologically confirmed patients with superficial lymph node lesions. Conventional sonography was first performed, with 2-dimensional images described. Then VTIQ shear wave velocity (SWV) values of superficial lymph nodes were measured. With pathologic diagnosis as the reference standard, a receiver operating characteristic curve was generated to evaluate VTIQ efficacy in differential diagnosis of metastatic and nonmetastatic cervical lymph nodes. Of the 85 nodes, 44 and 41 were metastatic and nonmetastatic, respectively. The latter group included 24 and 17 hematologic/lymphatic system disease and reactive hyperplastic nodes, respectively. Shear wave velocity values of metastatic nodes were significantly higher than those of their nonmetastatic counterparts (P < .001). With an area under the curve (AUC) of 0.953 and SWV cutoff of 3.27 m/s, accuracy, sensitivity, and specificity were 89.4%, 88.6%, and 90.2%, respectively, for distinguishing metastatic and nonmetastatic nodes. An AUC of 0.943 and SWV cutoff of 3.23 m/s yielded accuracy, sensitivity, and specificity of 88.2%, 88.6%, and 87.5% for differentiating metastatic from hematologic/lymphatic system disease nodes. Finally, an AUC of 0.968 and SWV cutoff of 3.27 m/s yielded accuracy, sensitivity, and specificity of 90.2%, 88.6%, and 94.1% for differentiating metastatic from reactive hyperplastic nodes. Virtual Touch tissue imaging quantification is efficient in differential diagnosis of metastatic and nonmetastatic cervical lymph nodes.

Application of contrast-enhanced ultrasound in differential diagnosis of cervical lymph nodes

Objective To evaluate the ability of contrast-enhanced ultrasonography (CEUS) in differentiate reactive lymph node, metastatic lymph node and lymphoma. Methods In a prospective study CEUS was performed in 129 patients with cervical lymph node enlargement. The entire process were recorded and preserved in DICOM format. The results were registered with Sonoliver. The receiver operating characteristic curve (ROC curve) analysis was performed to find the corresponding cutoff values. The selected node was removed surgically and submitted for histology. Results Of all the nodes, 26 were reactive nodes, 85 were metastases and 18 were lymphoma. Enhancement pattern was the most accurate way to characterize lymph nodes. The enhancement pattern of reactive lymph nodes was homogeneous and most of them were enhanced by lymphatic type while the metastatic lymph nodes were inhomogeneously enhanced or weakly enhanced by peripheral type. Lymph node lymphoma usually had no fixed enhancement pattern.Arrive time (AT), rise time (RT), time to peak (TTP), mean transit time (mTT), maximum intensity(IMAX), under the curve (AUC), rising slope(Kup), semi descending slope(Kdown) and perfusion index (PI) were significantly different in the three groups(P 0.05). When TTP≥7.74 s, mTT≥26.54 s, metastatic lymph nodes were considered. When RT≥4.62 s, TTP≥7.74 s, mTT≥28.32 s, reactive lymph nodes were not considered. Conclusions Dynamic contrast-enhanced ultrasound image and enhancement pattern can distinguish neck lymph nodes while the optimal cut-off point time of the time-intensity curve parameters can further contribute to the identification of lymph nodes. Key words: Contrast-enhanced ultrasound; Lymph nodes; Diagnosis, differential

A retrospective study of dual-energy CT for clinical detecting of metastatic cervical lymph nodes in laryngeal and hypopharyngeal squamous cell carcinoma

Conclusion: After the reconstruction of imaging in dual-energy CT gemstone spectral imaging, the ratio of the two slopes curves, the target lymph node and primary lesion, respectively, might contribute to the clinical diagnosis of cervical lymph nodes in laryngeal and hypopharyngeal squamous carcinoma. Objective: To investigate the value of the dual-energy CT gemstone spectral imaging for clinical detecting of metastatic cervical lymph nodes in laryngeal and hypopharyngeal squamous carcinoma. Methods: Forty-seven cases who were suffering from laryngeal or hypopharyngeal squamous carcinoma and had complete clinical and pathological data were included, and 79 cervical lymph nodes were studied retrospectively (including 31 metastatic nodes and 48 non-metastatic nodes). Contrast-enhanced energy spectral imaging and reconstruction were performed. After the reconstruction, the slope of the curve in the target lymph node and the lesion were calculated. The ratio of the two slopes was studied. The pathological data of cervical lymph node and primary lesion were also collected. Results: The ratios were 1.20 ± 0.09 and 0.82 ± 0.12 in metastatic and non-metastatic lymph nodes, respectively. The difference was statistically significant (p < 0.05). The ratio was positively correlated to the stasis of lymph nodes only, rather than their morphological appearance, the pathological classification, or the individual difference (p < 0.05).

Value of elastography and fine flow imaging in differential diagnosis of cervical lymph nodes

Objective To explore the diagnostic value of ultrasonic elastography and fine flow imaging in differential diagnosis of cervical lymph nodes.Methods Totally 87 lymph nodes were examined with ultrasonic elastography,fine flow and conventional ultrasonography.The results were confirmed with postoperative pathology or fine-needle biopsy as well as follow-up.Using consistency check of Kappa and ROC curve to analyse the accuracy of three types of ultrasonic examination.Results Taking the results of postoperative pathology or fine-needle biopsy as well as follow-up as golden standards,the Kappa value of conventional ultrasonography was poor (Kappa =0.153,P =0.078),fine flow was moderate (Kappa =0.526,P ＜0.01) and ultrasonic elastography was better (Kappa =0.741,P ＜0.01).The area under ROC of ultrasonic elastography,fine flow and conventional ultrasonography was 0.899 (P ＜0.01),0.787 (P ＜0.01) and 0.568 (P =0.241),respectively.Conclusions Ultrasonic elastography is more valuable to differentiate malignant from benign lymph nodes. Key words: Ultrasonograpyh; Elasticity imaging techniques ; Lymph nodes

Evaluation of ultrasound application in diagnosis and clinical staging of thyroid cancers.

Objectives: The usage of Ultrasonography (US) in the diagnosis and management of patients with thyroid nodules and thyroid cancer is increasing. This method is also advocated for the pre-operative and post-operative diagnosis of cervical lymph node (LN) metastases. This article is trying to figure out the correlation between ultrasound features and pathological classification of thyroid carcinoma (TC). Materials and Methods: A total of 407 cases of patients with TC were selected from records between 2000 and 2006, which were used to analyze and compare the ultrasound features in different pathologic classification of TC. We grouped the US typing of TC according to the ultrasound features. Then, we implemented pre-surgery evaluation of TC by ultrasound assessment. Results: We classified these patients into six groups by ultrasound: (1) classical, (2) non-typical, (3) microminiaturize, (4) diffuse sclerosing, (5) medullary, and (6) undifferentiated. Ultrasonographic types of papillary TC: (1) classical, (2) microminiaturize, (3) diffuse, (4) cystic, (5) peripheral, (6) multi-nodules, (7) invasive, and (8) complicated Hashimoto. Grouping of the ultrasonic type of cervical LN metastasis: (1) cystic, (2) micro calcification, (3) macro-lymph, (4) microminiaturize, and (5) invasive. The ultrasound assessment of clinical staging had a higher sensitivity rate and specificity, and the accuracy rate of T stage was 93.9%. Conclusion: Ultrasound is a useful tool in the evaluation, characterization, quantification, and location of TC and cervical LN metastasis.

Value of immunohistochemistry in the diagnosis of malignant cervical lymph nodes

The cervical lymph nodes are relevant due to the diversity of clinical entities. The use of immunohistochemistry is a real method to elucidate the diagnosis of adenopathy, both primary and metastatic neoplasms. ObjectiveTo assess the value of immunohistochemistry in the diagnosis of cervical lymph nodes malignancies. MethodRetrospective study of the database histopathological specimens from 2009 to 2011. ResultsOut of 32 biopsies of cervical lymph nodes, in 16 (50%) the immunohistochemistry was employed, being 68.75% (11) in hematological neoplasms and 31.25% (5) in carcinomas. It was used in all cases of lymphoma. ConclusionThe immunohistochemistry was used in 50% of the biopsies of lymph nodes under suspicion of malignancy, being 31.25% in epithelial lesions and 68.75% in lymphoproliferative lesions.