Transcutaneous Ultrasound: Elastographic Lymph Node Evaluation. Current Clinical Applications and Literature Review.
Distinguishing malignant versus benign lymphadenopathies is a major diagnostic dilemma in clinical medicine. Metastatic deposits in normal-sized lymph nodes (LNs) can be smaller than a millimeter, thus presenting a diagnostic challenge. In most clinical settings, however, enlarged LNs detected on imaging need to be classified as malignant or benign. Ultrasound seems to be a very reliable method for LN characterization because of the high resolution, especially in the subcutaneous areas. However, B-mode and Doppler-ultrasound criteria for characterization of a lymphadenopathy as benign or malignant are lacking specificity. Newer methods such as elastography seem to be valuable for identifying metastatic deposits within LNs and may help discriminate malignant and benign LNs. This review summarizes the different elastographic methods available and provides an overview of the relevant publications. According to the literature, elastography can be used for identifying metastatic deposits, to guide fine needle aspiration and to non-invasively choose the most suspicious LN of a group of enlarged LNs for targeted biopsy.
Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany; Département d'imagerie médicale, Clinique des Cévennes, Annonay, France.
Liliana
L
Chiorean
Northeastern Ohio Medical University, Rootstown, Ohio, USA; Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, UK.
Richard G
RG
Barr
Southwoods Imaging, Youngstown, Ohio, USA.
Barbara
B
Braden
Innere Medizin, Krankenhaus Märkisch Oderland, Strausberg, Germany.
Christian
C
Jenssen
Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany.
Xin-Wu
XW
Cui
Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Michael
M
Hocke
Medical Department, Helfenstein Klinik, Geislingen, Germany.
Andreas
A
Schuler
Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany. Electronic address: Christoph.dietrich@ckbm.de.
Christoph F
CF
Dietrich
D054459:Elasticity Imaging Techniques; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D014465:Ultrasonics
Elastography; Imaging; Lymph node; Shear wave elastography; Staging; Strain; Ultrasound