The Diagnostic Value Of Real-time Tissue Elastography In Cervical Malignant Lymphadenopathy

Purpose:To explore the diagnostic value of Real-time Tissue Elastography(RTE) in cervical malignant lymphadenopathy.Materials and Methods:From April to November2012,49patients with68cervical malignant lymphadenopathies were were dissected.30cervical malignant lymphadenopathies were lymphoma and38were metastatic tumor in68cervical malignant lymphadenopathies confirmed by clinic biopsy and surgical pathology. The objective lymph nodes were divided to the group of lymphoma and the group of metastatic tumor. Hitachi HV900ultrasound was used in this study.The enlarged lymph nodes were found by ultrasound,then the strain images and strain ratio were calculated by RTE with the measure software. The comparison between groups was made by t test.With pathologic diagnosis as the golden standard,ROC curves were obtained to assess the performance of the stain ratio and the scores of grade.The area under curves of the stain ratio and the scores of grade were computed.The comparison between the area under curves was made by Z testp<0.05for the difference was statistically significant.Results:The average of the strain ratio in the group of lymphoma was lower than the group of metastatic tumor (1.27±0.61vs2.61±0.68), and the difference between the two groups has statistically significant (P=0.000); The average of the score in the group of lymphoma was lower than the group of metastatic tumor (1.80±0.52vs2.64±0.54), and the difference between the two groups has statistically significant (P=0.000); The stiffness of lump nodes in the group of lymphoma was lower than the group of metastatic tumor.Drawing ROC curves, the area under curve of the strain ratio was0.866; The area under curve of the score was0.86. The strain ratio and the score had high diagnosis value for malignant lymphadenopathies.There were no significant differences between the area under curve of the strain ratio and the scores’(P=0.5018).2.12was the best cutoff point of the strain ratio for differentiating lymphomas from metastatic tumors.The numerous of the strain ratio lower than2.12were considerd to lymphoma and the numerous higher than2.12were considerd to metastatic tumor.Its senstivity,specificity and accuracy were96.7%、60.5%and76.5%.2.3was the best cutoff point of the score for differentiating lymphomas from metastatic tumors.The numerous of the score lower than2.3were considerd to lymphoma and the numerous higher than2.3were considerd to metastatic tumor.Its senstivity,specificity and accuracy were83.3%、71.1%and76.5%.Conclusion:The strain ratio and the elastography scores could provide a new way of differentiating lymphomas from metastatic tumors and quantitaively evalute the stiffness of lymphadenopathies providing more help for enhancing the rate of diagnosis.