The Value Of Shear Wave Elastography In Benign And Malignant Cervical Lymph Nodes

Objective:Shear wave elastography(SWE)was applied to determine the elastic moduli of the lymph nodes.And compared with gray-scale ultrasound,color Doppler Flow Imaging(CDFI)to evaluate its application value in the diagnosis of benign and malignant diseases of cervical lymph nodes.Methods:Ultrasound ultrasound,CDFI and SWE were performed on 80 lymph nodes.The conventional ultrasound signs and the elastic modulus values of each lymph node—Emean,Emax,Emin,Esd and Eratio were recorded.Then,ultrasound-guided puncture biopsy was performed.Using the pathological results as the gold standard,the receiver's working curve(ROC curve)of conventional ultrasound and each elastic modulus value was drawn.The area under the ROC curve of each index was calculated(Area under curve,AUC)and the best cut-off value for each indicator was set.Then compared the value of SWE with conventional ultrasound in the diagnosis of benign and malignant lymph nodes.Results:1.Among the 80 lymph nodes included in the experiment,29 were benign lymph nodes and 51 were malignant lymph nodes2.In the lymph node routine ultrasound(grayscale ultrasound and CDFI)signs,short diameter,long diameter/short diameter(L/S),hilum,boundary,internal echo and blood flow distribution had certain value in the diagnosis of benign and malignant lymph nodes.3.In SWE,Emean,Emax,Esd and Eratio values of malignant lymph nodes were higher than those of benign lymph nodes,and the differences were statistically significant(P<0.05).The optimal critical values of elastic modulus for the diagnosis of malignant lymph nodes were 15.15kpa,39.45kpa,6.65kpa and 2.15,respectively.The area under ROC curve(AUC)of Emax was the largest,significantly higher than that of Emean and Eratio,and the difference was statistically significant(P<0.05),but the difference between Emax and Esd was not statistically significant(P=0.357).4.Compared with gray-scale ultrasound and CDFI,the AUC of Emax was larger and the difference was statistically significant(P<0.01).The specificity of SWE in the diagnosis of benign and malignant lymph nodes was higher than that of gray scale ultrasound,and the sensitivity was higher than that of CDFI,the difference was statistically significant(all P<0.05).Conclusions:1.Real-time shear wave elastography can qualitatively and quantitatively reflect the tissue hardness of cervical lymph nodes.Emax,Esd,Emean and Eratio values are meaningful for the differential diagnosis of benign and malignant diseases.The diagnostic value of the maximum elastic modulus value Emax and the elastic modulus standard deviation Esd is higher than the other two2.Compared with gray-scale ultrasound and CDFI,SWE has higher accuracy and has important clinical value in the diagnosis of benign and malignant cervical lymph nodes.It is worthy of further application and promotion.