Diagnostic value of high-frame-rate contrast-enhanced ultrasound and contrast vector imaging for superficial lymph node lesions.

PURPOSE

To explore the diagnostic performance and feasibility of high-frame-rate contrast-enhanced ultrasound (HFR CEUS) combined with contrast vector imaging (CVI) in detecting benign and malignant superficial lymph nodes (SLNs).

MATERIALS AND METHODS

In this single-center prospective study conducted between October 2023 and February 2024, 38 consecutive patients with suspected SLN lesions underwent B-mode US, HFR CEUS examination, and post-processing CVI analysis. Their diagnosis was confirmed using fine-needle aspiration cytologic or histopathologic examination. The diagnostic efficacy of HFR CEUS alone and the combination of HFR CEUS with CVI for benign and malignant LN diagnosis was compared and the significance of other CVI parameters was evaluated.

RESULTS

The final data set included 38 participants (mean age, 56 ± 16 years) with 42 SLN lesions. Both HFR CEUS alone and HFR CEUS combined with CVI examination showed differences in the contrast patterns of benign and malignant SLNs (all P < 0.001). The contrast pattern of benign LNs was predominantly centrifugal, while that of malignant LNs was primarily centripetal and hybrid and they were more likely to exhibit perfusion defects. The comparison between CVI combined with HFR CEUS examination and pathological results for the diagnosis of benign and malignant LNs showed a high level of consistency with a kappa value of 0.81. Comparison with HFR CEUS alone resulted in a kappa value of 0.66.

CONCLUSION

HFR CEUS combined with CVI examination demonstrated a good performance in distinguishing benign and malignant SLNs.