The Clinical Value Of Contrast-enhanced Ultrasound In Superficial Lymphadenopathy Qualitative Diagnosis

Aim: Discuss the application value of the contrast enhanced ultrasound in diagnose of the superficial lymph nodes.Method: 94 superficial enlarged lymph nodes of the 94 patients were diagnosed by 2D color Doppler, and the results were compared with histopathology in order to evaluate the accuracy of the 2D color Doppler. The contrast agent SonoVue is produced by Bracco Company and was prepared to 5ml milky microbubble suspension. Each patient was administrated with a bolus injection with the SonoVue (2.4ml) into their elbow vein. 5ml Saline was injected to wash the pipe. All the patients were diagnosed by PHILIPS iu22 color ultrasonic apparatus, with L9-3 transducer of 3-9MHz. Examination time is 120 second per person. Then the saved images were replayed. So the enhanced lymph nodes could be observed and analyzed. The automatic tracing Time strength curve was used to observe the index which included the contrast arrival time(AT), time to peak(TTP) and peak intensity(PI). After the exam, all the lymph nodes were cut to do the pathology exam and the pathologic results were compared to the time strength analysis. Use SPSS11.0 to analyze the results. Measurement data expressed as ( x±s) and comparison between the groups used unpaired t- test, p<0.05 for the difference was statistically significant.Results: Pathologic results showed that 44 of the 94 enlarged lymph nodes were benign, 33 were metastatic tumors, and 17 were lymphoma. 26 of the 44 benign lesions were benign, 11 were diagnosed as metastatic tumors and 7 were diagnosed as lymphoma. 7 of the 33 metastatic tumors were diagnosed as benign lesion, 19 were diagnosed as metastatic tumors and 9 were diagnosed as lymphoma. 6 of the 17 lymphoma diagnosed as benign, 7 were diagnosed as metastatic tumors and 4 were diagnosed as lymphoma. The CEUS showed that inflammatory lymph nodes appeared even significant perfusion (39/44)), metastatic lymph nodes appeared uneven hypertransfusion (25/33) or uneven hypoperfusion (7/33) and the lymphoma appeared even significant perfusion (6/17) or nonperfusion (9/17). The sensitivity of the CEUS was 84%, the specificity was 79% and the accuracy was 80%. After the time strength quantitative analysis Gamma-variate the Peak intensity of acoustics and the area under the curve of the benign lymph nodes were both higher than the metastatic lymph nodes and lymphoma. Compared the Time-strength curve quantitative parameter of the three groups we found that the AT and the TTP had no significant deviation between the benign lymph nodes group and the metastatic lymph nodes group (p>0.05). But the PI was larger than the metastatic lymph nodes group (p<0.05).Conclusion: The perfusion characteristics of the lymph nodes after the lymphadenography provide some valuable basis to the diagnosis of the enlarged superficial enlarged lymph nodes. The time constant strength quantitative analysis Gamma-variate after the lymphadenography has important value in diagnosing the enlarged lymph nodes, and the area under curve can help to judge the tumor properties.