Shear wave elastography and dynamic contrast enhanced MRI in the differential diagnosis of benign and malignant cervical lymph nodes:a comparison study
ZHANG Wei, ZHOU Yang, CHENG Juan. Shear wave elastography and dynamic contrast enhanced MRI in the differential diagnosis of benign and malignant cervical lymph nodes:a comparison study[J]. Journal of Clinical Ultrasound in Medicine, 2021,23(3):203-207.
Objective To analyze the value of shear wave elastography and dynamic contrast enhanced MRI(DCE-MRI) in the differential diagnosis of benign and malignant cervical lymph nodes.Methods A total of 86 patients with lymphadenopathy who were admitted to our hospital were selected
according to the results of pathology
they were divided into benign group(32 cases
112 lesions)and malignant group(54 cases
184 lesions)
and all of them underwent shear wave elastography and DCE-MRI. The shear wave elastography parameters including lymph nodes and the surrounding fat tissue elasticity ratio(E-ratio)
mean elasticity(E-mean)
maximum elasticity(E-max)
and quantitative parameters of DCE-MRI including volume transfer constant(Ktrans)
rate constant(Kep)
extravascular extracellular space volume ratio(Ve)between two groups were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of the two inspection methods.Results Compared with the benign group
the E-ratio
E-mean
and E-max of malignant group were increased
there were significant differences(all P<0.05). Compared with the benign group
Kep was increased in malignant group
Ve was decreased
there were significant differences(both P<0.05).There was no significant difference in Ktrans between the two groups.ROC curve analysis showed that the areas under the curve(AUC)of E-ratio
E-mean
E-max and the three combined indicators for diagnosing malignant lymph nodes were 0.841
0.859
0.846
0.881
respectively
and the AUC of Kep
Ve and the two combined indicators were 0.742
0.776
0.926
respectively.When the cut-off value was 0.573
the diagnostic sensitivity and specificity of the three combined indicators of shear wave elastography were 89.7% and 88.4%
respectively.When the cut-off value was 0.663
the diagnostic sensitivity and specificity of the two combined indicators of DCE-MRI were 91.5%and 88.4%
respectively.Conclusion For the diagnosis of cervical benign and malignant lymph nodes
both shear wave elastography and DCE-MRI quantitative parameters have high diagnostic value.Shear wave elastography has higher diagnostic value in terms of single index
and DCE-MRI has higher diagnostic value in terms of combined index.