The possibilities of ultrasound elastography in diagnostics of lymphomatous changes of superficial lymph nodes

Abstract

Objective: to evaluate the possibilities of strain elastography (SE) in eSie Touch mode and shear wave elastography (SWE) with ARFI (Acoustic Radiation Force Impulse) technology in Virtual TouchTM Tissue Imaging (VTI) for diagnostics lymphomatous superficial lymph nodes (LN).Materials and methods. The prospective study included 168 patients with enlarged superficial LN. Based on a previous histological examination, patients were divided into three groups: group 1 (n = 108) – patients with lymphomas; group 2 (n = 30) – patients with metastatic superficial LN; group 3 (n = 30) – patients with reactive (inflammatory) changes in superficial LN. All patients underwent SE and SWE elastography of the enlarged LN using eSie Touch and VTI modes respectively.Results. The SE data: reactive LN was characterized by elastotypes 1 and 2 with a predominance of elastic structure in 90.0 % of cases. In patients with lymphomas, the elastotype 3 was more often determined (58.3 %). The stiffest LN with the elastotype 4 were metastatic LN, detected in 66.7 % of patients from this group. The results of VTI elastography showed that the stiffest structure is typical for metastatic LN (elastotypes 5–6 in 63.3 % of cases). Lymphomas had an intermediate degree of stiffness (elastotypes 3–4 in 81.5 % of cases). The lowest indicators of elasticity were found in patients with reactive LN (elastotypes 1–2 in 73.4 % of cases).Conclusion. The qualitative assessment of superficial LN stiffness, both using SE and VTI elastography, demonstrated statistically significant differences in the frequency of various types of superficial LN elastograms with lymphomatous, metastatic and reactive changes, which allows for more accurate differential diagnosis between these types of lymphadenopathy.