Aim: To evaluate the diagnostic usefulness of elastography, B-mode and power Doppler sonography in differentiation between malignant and reactive cervical lymph nodes in children.
Methods: 890 lymph nodes (160 malignant and 730 reactive) from 49 children with cervical lymphadenopathy were examined by ultrasound in the prospective study. All the lymph nodes were examined by B-mode ultrasonography, power Doppler ultrasonography and elastography. 4 scores elastographic classification (ES) proposed by Furukawa and muscle-to-lymph strain ratio (SR) were used to evaluate elastograms of lymph nodes.
Results: The sensitivity, specificity and accuracy of 4 scores elastographic classification were respectively: 81,9%, 96% and 93,5%. The strain ratio of 1,4 was taken as the cutoff point with the sensitivity, specificity and accuracy: 81,3%, 86,6% and 85,6%. Short axis to long axis ratio (S/L) was the best criterion of B-mode ultrasound in differentiation between malignant and benign lymph nodes with the sensitivity, specificity and accuracy respectively: 81,9%, 81,4% and 81,5%. The sensitivity, specificity and accuracy of the vascular patterns in power Doppler were 78,1%, 100% and 96,1%.
Conclusion: Elastography may provide new opportunities in differentiation between malignant and benign cervical lymph nodes in children. The combination of B-mode, PD and elastography can be helpful to improve the initial diagnosis of the causes of cervical lymphadenopathy in childhood.
