Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
Institute of Clinical Medicine, Unit of Radiology, University of Eastern Finland, Kuopio, Finland.
PLoS One. 2022 Mar 28;17(3):e0265802. doi: 10.1371/journal.pone.0265802. eCollection 2022.
To assess the ability of 2D-Shear wave elastography (2D-SWE) to evaluate its reproducibility, to define the optimal orientation and size of the region of interest (ROI), and to differentiate benign from malignant inguinal lymph nodes (LNs).
Thirty-two suspicious inguinal LNs from 21 patients were evaluated with 2D-SWE. SWE measurements were obtained in two orthogonal planes. To investigate reproducibility, sensitivity and specificity, circular ROIs with a diameter of 1 mm, 2 mm, 3 mm and 5 mm were placed on the cortex of the LNs. Additionally, one freehand ROI was drawn covering majority of the LN. Two observers performed five sets of SWE measurements for each ROI size. All LNs underwent core needle biopsy or were surgically removed.
The 3 mm ROI for Mean-E in axial plane showed high interrater agreement [intraclass correlation coefficient (ICC) 0.899] with the cut-off value of 7.31 kPa resulting in 88.9% sensitivity and 60.9% specificity for differentiating malignant from benign LNs. In benign LNs, mean elasticity of the ROI was lower (7.68 ± 3.82 kPa; range, 3.41-15.40 kPa) compared to the malignant LNs (15.81 ± 10.61 kPa; range, 3.86-36.45 kPa).
The most reproducible way to measure stiffness in inguinal LNs is a 3 mm circular ROI centered on the cortex of the LN in axial plane. Elasticity values were higher in the malignant LNs reflecting the stiffer nature of the metastatic LNs. 2D-SWE offers a noninvasive ultrasonographic tool to assess superficial inguinal lymph nodes with high reproducibility.
评估二维剪切波弹性成像（2D-SWE）评估其可重复性的能力，定义感兴趣区（ROI）的最佳方位和大小，并区分腹股沟良性和恶性淋巴结（LNs）。
对 21 例 32 个可疑腹股沟淋巴结进行 2D-SWE 评估。SWE 测量在两个正交平面进行。为了研究可重复性、敏感性和特异性，在淋巴结皮质上放置直径为 1mm、2mm、3mm 和 5mm 的圆形 ROI。此外，还绘制了一个自由形状 ROI，覆盖了大部分 LN。两位观察者对每个 ROI 大小进行了五组 SWE 测量。所有 LNs 均进行了芯针活检或手术切除。
轴向平面的 3mm ROI 用于平均 E 值，具有高的观察者间一致性[组内相关系数（ICC）0.899]，其截断值为 7.31kPa，对区分恶性和良性 LNs 的敏感性为 88.9%，特异性为 60.9%。在良性 LNs 中，ROI 的平均弹性较低（7.68±3.82kPa；范围，3.41-15.40kPa），而恶性 LNs 较高（15.81±10.61kPa；范围，3.86-36.45kPa）。
在轴向平面上以淋巴结皮质为中心的 3mm 圆形 ROI 是测量腹股沟淋巴结硬度最具可重复性的方法。恶性 LNs 的弹性值较高，反映了转移性 LNs 的僵硬特性。2D-SWE 提供了一种非侵入性超声工具，可高度重现性地评估浅表腹股沟淋巴结。
