Publication details
Contrast-enhanced ultrasonography compared to gray-scale and power doppler in the diagnosis of peripheral lymphadenopathy
| Authors | |
|---|---|
| Year of publication | 2013 |
| Type | Article in Periodical |
| Magazine / Source | European Journal of Radiology |
| MU Faculty or unit | |
| Citation | |
| Web | Full Text |
| Doi | http://dx.doi.org/10.1016/j.ejrad.2012.12.008 |
| Field | Other specializations of internal medicine |
| Keywords | Lymph nodes; Ultrasonography; Color Doppler; Contrast media |
| Description | Objectives: The aim of the study was to evaluate the ability of contrast-enhanced ultrasonography compared to gray-scale B-mode and power Doppler in distinction between benign and malignant lymphadenopathy. Methods: In a prospective study ultrasonography was performed in 133 patients with superficial lymphadenopathy (73 men, 60 women; mean age of 51 years, range: 18-86 years), who were examined for palpable mass in the neck, axilla or groin (104/133) and for clinical suspicion of lymphoma on the basis of positive PET/CT (29/133). 133 nodes were examined, subsequently preoperatively localized under ultrasound guidance and surgically removed; longitudinal to transverse ratio, location of nodal vessels by power Doppler and pattern of enhancement by contrast-enhanced ultrasonography with 1.5 ml intravenous bolus of sulphur hexafluoride contrast agent were documented. The ultrasound findings were compared with the histology. Results: Of all the nodes extirpated, 33 were benign, 100 were malignant (40 metastases, 60 lymphomas). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of conventional techniques were 72%, 63.6%, 85.7%, 42.9%, 67.8% for longitudinal to transverse ratio; 73%, 60.6%, 84.9%, 42.6%, 68.3% for power Doppler versus 98.0%, 54.5%, 86.7%, 90.0%, 76.3% for contrast-enhanced ultrasonography according to Receiver Operating Characteristic analysis. Conclusions: Receiver Operating Characteristic analysis confirmed higher degree of diagnostic accuracy of contrast-enhanced ultrasonography in comparison with conventional techniques. Evaluation of nodal perfusion after intravenous administration of microbubble contrast agent can be helpful in differentiation of benign from malignant nodes. |