Diagnostic value of multimodal ultrasonographic techniques in evaluation of lymphadenopathy in the neck

Abstract

Background Recent ultrasound (US) imaging techniques, including high-resolution gray-scale, color, power, pulsed Doppler, and strain sono-elastography, are recent modes for US evaluation. Aim This prospective study aimed to review the value of the recent US modes in differentiating causes of lymph node enlargement in benign and malignant conditions. Patients and methods The study included 30 patients with enlarged cervical lymph nodes throughout the period from August 2022 to September 2023. Multimodal US techniques were used for all cases. Results In benign lesions, the lymph node size was taken. The shape index range was 0.31–0.66 with a mean=0.48 ± 0.9. Using Doppler US, they showed elevated hilar flow without peripheral vascularity. Using elastography, these nodes gave soft strain values range=0.60–1.00 with a mean=0.80 ± 0.2. In malignant lesions, the lymph node shape index range=0.55–0.81 with a mean=0.68 ± 0.4. Using Doppler, the nodes showed increased vascularity in most patients and avascular nodes in others. Using elastography, these nodes gave hard strain values with a range=1.70–11.75 and a mean=4.70 ± 5.0. Conclusion The use of multimodal US imaging (gray scale, color Doppler, pulsed Doppler, power Doppler, and elastography), in addition to the clinical history of the disease, differentiates benign from malignant causes of lymph nodes enlargement and are useful in selecting the lymph node for fine-needle aspiration cytology or biopsy.