scholarly journals The value of multimodal ultrasonography in differential diagnosis of tuberculous and non-tuberculous superficial lymphadenitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Chu ◽  
Ying Zhang ◽  
Wenzhi Zhang ◽  
Dan Zhao ◽  
Jianping Xu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Mycobacterium Tuberculosis ◽  
Lymph Nodes ◽  
Color Doppler ◽  
Tuberculous Lymphadenitis ◽  
Contrast Enhanced Ultrasound ◽  
Doppler Examination ◽  
Contrast Enhanced ◽  
Sensitivity Specificity ◽  
Multimodal Method

Abstract Background To investigate the value of multimodal ultrasonography in differentiating tuberculosis from other lymphadenopathy. Methods Sixty consecutive patients with superficial lymphadenopathy treated at our hospital from January 2017 to December 2018 were categorized into four types based on the color Doppler ultrasound, five types based on contrast-enhanced ultrasound, and five types based on elastography. Sensitivity and specificity were calculated of all the three imaging, including color Doppler examination, contrast-enhanced ultrasound and one individual multimodal method, for detecting lymph nodes. Results A total of 60 patients were included in the final analysis. Of those, Mycobacterium tuberculosis was positive in 38 patients and negative in 22 patients. Among the 38 patients who were positive for Mycobacterium tuberculosis, of which 23 had a history of pulmonary tuberculosis, accounting for 60.53% of the positive cases, and the remaining patients did not combine lesions of other organs. Among the 60 superficial lymph nodes, 63.3% presented with tuberculous lymphadenitis. The sensitivity, specificity, and accuracy of the color Doppler examination were 73.68%, 68.18%, and 71.67%, respectively. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound were 89.47%, 63.64% and 80.00%, respectively. The sensitivity, specificity and accuracy of the elastography were 63.16%, 63.64% and 63.33%, respectively. The sensitivity, specificity and accuracy of one individual multimodal method were 42.11%, 95.45% and 61.67%, respectively. The sensitivity, specificity and accuracy of all modes combined were 100.00%, 27.27% and 73.33%, respectively. Conclusion Multimodal ultrasonography has high predictive value for the differential diagnosis of superficial tuberculous lymphadenitis.

scholarly journals Multiparametric ultrasound diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lymphoma

2019 ◽  
Vol 8 (4) ◽  
pp. 37-44 ◽  
Author(s):  
E. V. Kovaleva ◽  
T. Yu. Danzanova ◽  
G. T. Sinyukova ◽  
P. I. Lepedatu ◽  
E. A. Gudilina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Shear Wave ◽  
Malignant Tumors ◽  
Shear Wave Elastography ◽  
Doppler Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Multiparametric Ultrasound

In this article, based on two clinical examples, the possibilities of multiparametric ultrasound in the differential diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lym - phoma, are evaluated. Multiparameteric ultrasound includes B-mode, color and energy Doppler imaging, strain elastography, shear wave elastography and contrast-enhanced ultrasound (CEUS). Standardization and reproducibility of these ultrasound techniques will allow to objectify the study, obtaining specific indicators of shear wave velocity in the zones of interest and specific signs of contrast enhancement, which can be used as impor tant differential diagnostic tool in oncology.

scholarly journals Reassessing the Value of Contrast-Enhanced Ultrasonography in Differential Diagnosis of Cervical Tuberculous Lymphadenitis and Lymph Node Metastasis of Papillary Thyroid Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Xu Zhang ◽  
Lingling Wang ◽  
Na Feng ◽  
Tu Ni ◽  
Wei Tang
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Tuberculous Lymphadenitis ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Contrast Enhanced Ultrasonography

AimWe aimed to evaluate the ability of contrast-enhanced ultrasonography (CEUS) to perform differential diagnosis of cervical tuberculous lymphadenitis and lymph node metastasis from papillary thyroid cancer (PTC).MethodsWe analyzed 102 enlarged cervical lymph nodes as diagnosed by conventional ultrasound (US) and CEUS. The US and CEUS enhancement pattern and the time intensity curve (TIC) of the metastatic lymph nodes or tuberculous lymph nodes were compared following standard pathological protocols. The TIC included peak time (TTP), peak intensity (PI), and area under the gamma curve (AUC).ResultsPathological results demonstrated that 48 out of the 102 enlarged lymph nodes were lymph node metastasis from PTC, while 54 were tuberculous lymphadenitis. There was statistically significant differences in hyperechoic islands, pulse-like enhancement, and asynchronous enhancement between tuberculous lymphadenitis and lymph node metastasis (P < 0.05), but their diagnostic sensitivity and specificity were unsatisfactory. In addition, our data did not show statistically significant difference in enhancement direction, enlarged range on CEUS, and perfusion defect (P > 0.05). Similarly, quantitative parameters such as PI, TTP, and AUC did not yield significant differences between the groups.ConclusionTaken together, the present results demonstrate that CEUS can provide valuable information on lymph node blood flow, which can be used to identify tuberculous lymphadenitis and lymph node metastasis of PTC.

scholarly journals The diagnostic value of contrast-enhanced ultrasound for cervical tuberculous lymphadenitis

2022 ◽  
pp. 1-11
Author(s):  
Dan Zhao ◽  
Ning He ◽  
Ya-Qin Shao ◽  
Xiu-Lei Yu ◽  
Jie Chu ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
High Specificity ◽  
Diagnostic Value ◽  
Diagnostic Sensitivity ◽  
Tuberculous Lymphadenitis ◽  
Diagnostic Efficiency ◽  
Contrast Enhanced Ultrasound ◽  
Imaging Findings ◽  
Contrast Enhanced ◽  
Heterogeneous Enhancement

OBJECTIVE: To investigate the value of contrast-enhanced ultrasound (CEUS) for the diagnosis of cervical tuberculous lymphadenitis (CTL). METHODS: The cohort study included 203 consecutive patients diagnosed with cervical lymph node. Before pathological or laboratory confirmation, all patients underwent CEUS examination, and the imaging findings were analyzed afterward. The diagnostic efficiency of the CEUS imaging findings of CTL was evaluated. RESULTS: Nighty-seven patients of the 203 (47.8%) were pathologically or laboratory confirmed with a CTL diagnosis while the remainder (52.2%) were diagnosed with non-tuberculous lymphadenitis. Regarding the imaging findings of CEUS, it was more common in CTL patients to find a pattern of heterogeneous enhancement inside the lymph nodes relative to non-tuberculous patients [81.44% (79/97) vs 15.09% (16/106), P <  0.01]. The sensitivity of the feature in diagnosis for CTL was 81.44% and the specificity was 84.91%, resepectively. Furthermore, a pattern of peripheral rim-like enhancement had been notable in CTL patients compared with non-tuberculous patients [86.60% (84/97) vs 12.26% (13/106), P <  0.01], associating with a diagnostic sensitivity of 86.60% and a specificity of 87.74% . When it came to the combination of both imaging findings mentioned above, the features were more prominent in CTL patients than compared with non-tuberculous patients [74.23% (72/97) vs 5.66% (6/106), P <  0.01], with a diagnostic sensitivity of 74.23% and a high specificity of 94.34% . Regarding area under curve (AUC) for the ROC analysis, the feature of internal heterogeneous enhancement, peripheral rim-like enhancement, and both features were 0.832, 0.872, and 0.843. CONCLUSIONS: CEUS patterns of heterogeneous enhancement and peripheral rim-like enhancement of lymph nodes are helpful characteristics for the diagnosis of CTL.

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