Contrast-enhanced ultrasound of peripheral lymph nodes

JAKUBCOVÁ, Radka, Jakub FOUKAL, Karel BENDA, Eva BUDINSKÁ, Mojmír MOULIS and David ŠÁLEK. Contrast-enhanced ultrasound of peripheral lymph nodes. In European Congress of Radiology, Vienna, Austria. 2010. Available from: https://dx.doi.org/10.1594/ecr2010/C-2442.

Basic information

• Original name: Contrast-enhanced ultrasound of peripheral lymph nodes
• Authors: JAKUBCOVÁ, Radka (203 Czech Republic, guarantor, belonging to the institution), Jakub FOUKAL (203 Czech Republic, belonging to the institution), Karel BENDA (203 Czech Republic, belonging to the institution), Eva BUDINSKÁ (703 Slovakia, belonging to the institution), Mojmír MOULIS (203 Czech Republic, belonging to the institution) and David ŠÁLEK (203 Czech Republic).
• Edition: European Congress of Radiology, Vienna, Austria, 2010.

Other information

• Original language: English
• Type of outcome: Presentations at conferences
• Field of Study: 30000 3. Medical and Health Sciences
• Country of publisher: Czech Republic
• Confidentiality degree: is not subject to a state or trade secret
• WWW: DOI: 10.1594/ecr2010/C-2442
• RIV identification code: RIV/00216224:14110/10:00051349
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1594/ecr2010/C-2442
• Keywords in English: sulphur hexafluoride; ultrasound; lymphadenopathy

Abstract

Purpose: To evaluate the benefit of contrast-enhanced ultrasound compared to colour Doppler ultrasound in distinction between benign and malignant lymph nodes in pacients with peripheral lymphadenopathy. Methods and materials: Total number of 80 patients were examined (29 women, 51 men, age 22-86 years). Examinations were performed on Philips iU22 ultrasound machine using 17MHz probe natively for evaluation of pattern of node’s vascularization and 9MHz probe for evaluation of pattern of enhancement with 1,5 ml intravenous bolus of sulphur hexafluoride contrast agent (SonoVue, Bracco, Italy) using power modulation mode with mechanical index 0.04. According to the pattern of vascularization and enhancement the nodes were divided into group of benign and malignant ones. All nodes were extirpated, ultrasound and histological findings were correlated. Results: Total number of 84 lymph nodes were extirpated, 26 benign (30,9%) and 58 malignant (69,1%). Except for 4 nodes (4,8%) with hyperechoic center all nodes were hypoechoic. 8 nodes (9,5%) had no Doppler signal. According to ROC analysis senzitivity in comparison with native ultrasound examination increased from 77,6% to 98,3%, but specificity decreased from 84,6% to 80,4%. Overall accuracy of the method increased from 76,9% to 89,5%. Mann-Whitney U test confirmed larger maximum size of malignant nodes (p=0,024) and lower LT ratio (p<0,001). Metastasis and lymphoproliferative disorded could have been distinguished in case of malignant lymphadenopathy Conclusion: Contrast-enhanced ultrasound can detect changes in normal structure of a lymph node. Signs of malignancy are heterogeneous enhancement with peripheral rim, unenhancing center, areas of necrosis and postcontrast wash-out.