title: Value of Ultrasound Elastography in the Differential Diagnosis of Cervical Lymph Nodes: A Comparative Study With B-mode and Color Doppler Sonography.
abstract: OBJECTIVE
  The purpose of this study was to determine the usefulness of ultrasound elastography in the evaluation of enlarged cervical lymph nodes in comparison with B-mode and color Doppler sonography.
  
  
  METHODS
  A total of 220 lymph nodes in 168 consecutive patients who were referred for sonography of the neck were included in this study. B-mode sonograms were evaluated according to short-axis diameter, long-to-short-axis ratio, hilum, echogenicity, and microcalcification. For color Doppler sonography, 5 different patterns were defined according to vascularity. Elastographic patterns of the lesions were categorized to 5 main types. The mean strain index values were calculated for all lymph nodes. Histopathologic findings, clinical and laboratory data, and imaging findings were used as reference standards for the diagnosis of benign and malignant lymph nodes.
  
  
  RESULTS
  Of the 220 lymph nodes, 69.5% were diagnosed as benign, and 30.5% were diagnosed as malignant. The sensitivity, specificity, and accuracy of B-mode sonography were 97.0%, 31.4%, and 51.3%, respectively; the values were 76.1%, 82.4%, and 80.5% for color Doppler sonography and 82.1%, 56.2%, and 64.1% for elastography. The strain index cutoff value for the differentiation of benign and malignant lymph nodes was accepted as 1.7. The sensitivity, specificity, and accuracy of the strain index were 71.6%, 76.5%, and 75.0%.
  
  
  CONCLUSIONS
  Ultrasound elastography adds no additional value to combined B-mode and color Doppler sonography for differentiation of benign and malignant cervical lymph nodes.
authors: Department of Radiology, Erbaa State Hospital, Tokat, Turkey leylaacu@gmail.com.
authors: Leyla
authors: L
authors: Acu
authors: Department of Radiology, Gazi University, School of Medicine, Ankara, Turkey.
authors: Suna Özhan
authors: SÖ
authors: Oktar
authors: Department of Radiology, Batman State Hospital, Batman, Turkey.
authors: Rusen
authors: R
authors: Acu
authors: Department of Radiology, Gazi University, School of Medicine, Ankara, Turkey.
authors: Cem
authors: C
authors: Yücel
authors: Department of Otolaryngology, Etlik Zubeyde Hanim State Hospital, Ankara, Turkey.
authors: Süleyman
authors: S
authors: Cebeci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009333:Neck; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult
keywords: elastography; lymph node; lymphadenopathy; sonography; ultrasound education