Gaurav Gaurav, Bano Shahina, Gupta Prajwala
Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Indian J Radiol Imaging. 2024 Dec 17;35(3):418-423. doi: 10.1055/s-0044-1800881. eCollection 2025 Jul.
The aim of the study was to evaluate role of shear wave elastography (SWE) using a novel methodology for differentiation of benign and malignant cervical lymph nodes. SWE was performed on 38 patients who presented with cervical lymph adenopathy. Color-coded elasticity maps were obtained, from which the stiffest region of interest (ROI) with a diameter of 2 mm was chosen. Maximum and mean Young's modulus values (Kpa) were calculated in selected 2-mm ROI. Finally, the results were correlated with the fine needle aspiration cytology findings in all patients to assess the diagnostic accuracy, sensitivity, and specificity at a defined cutoff value for distinguishing between benign and malignant lymphadenopathies. There were 20 malignant cervical lymph nodes and 18 benign cervical lymph nodes. Malignant nodes showed significantly higher mean Young's modulus value (154.2 ± 46.19 kPa) compared with benign nodes (70.39 ± 30.76 kPa), with a -value of less than 0.0001. Our findings indicate that the mean Young modulus value within a standardized 2-mm ROI outperformed grayscale ultrasound in terms of diagnostic accuracy (92.1 vs. 78.9%), sensitivity (100 vs. 80%), and specificity (83.3 vs. 77.7%), with the established cutoff values for high diagnostic accuracy indicating malignancy as greater than 92 for mean Young's modulus with an area under the curve of 0.964. SWE using a standardized 2-mm ROI provides improved sensitivity and diagnostic accuracy for differentiation of benign and malignant lymph node lesions.
本研究的目的是评估使用一种新方法的剪切波弹性成像（SWE）在鉴别良性和恶性颈部淋巴结方面的作用。
对38例出现颈部淋巴结病的患者进行了SWE检查。获得了彩色编码弹性图，从中选择直径为2毫米的最硬感兴趣区域（ROI）。计算选定的2毫米ROI中的最大和平均杨氏模量值（千帕）。最后，将结果与所有患者的细针穿刺细胞学检查结果相关联，以评估在区分良性和恶性淋巴结病的定义临界值时的诊断准确性、敏感性和特异性。
有20个恶性颈部淋巴结和18个良性颈部淋巴结。恶性淋巴结的平均杨氏模量值（154.2±46.19千帕）明显高于良性淋巴结（70.39±30.76千帕），P值小于0.0001。我们的研究结果表明，在标准化的2毫米ROI内的平均杨氏模量值在诊断准确性（92.1%对78.9%）、敏感性（100%对80%）和特异性（83.3%对77.7%）方面优于灰阶超声，高诊断准确性的既定临界值表明，平均杨氏模量大于92时为恶性，曲线下面积为0.964。
使用标准化的2毫米ROI的SWE在鉴别良性和恶性淋巴结病变方面提供了更高的敏感性和诊断准确性。
