Reliability of sonoelastography in predicting pediatric cervical lymph node malignancy
| Autor: | Ahmed Mousa, Haytham Al-Arfaj, Mohamed Y Daoud, Amr M. El-Gibaly, Tamer A Sultan, Asmaa Al-Taher, Ossama M. Zakaria, Reema AlSadhan, Essam M Abdelbary, Hazem M Zakaria, Krishna Swaroop, Ahmed F Eid |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Biopsy Fine-Needle Lymph node biopsy Sonoelastography Lymphadenopathy Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cervical lymphadenopathy Biopsy medicine Humans Prospective Studies Child Lymph node Ultrasonography Interventional medicine.diagnostic_test business.industry Infant Reproducibility of Results General Medicine medicine.disease Lymphoma medicine.anatomical_structure Cervical lymph nodes 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Elasticity Imaging Techniques Surgery Female Radiology Lymph Lymph Nodes medicine.symptom business |
| Zdroj: | Pediatric surgery international. 34(8) |
| ISSN: | 1437-9813 |
| Popis: | Controversy exists as regards the best non-invasive diagnostic tool for pediatric cervical lymphadenopathy. The current work aimed to evaluate the reliability, sensitivity, specificity, and accuracy of sonoelastography in diagnosing benign and/or malignant pediatric cervical lymphadenopathy. Prospective study took place over a period of 4 years from January 2013 to December 2016. A total of 177 lymph nodes (LNs) in 128 children with an age ranging from 11 months to 12 years were recruited in this study. Patients were 77 males and 51 females with a ratio of 3:2. All patients underwent a thorough history taking and clinical examination of the neck focusing on the cervical lymph nodes. After that, a B-mode sonography, Color Doppler ultrasound, and Sonoelastography were performed. Elastographic patterns of 1–5 were evaluated, whereas patterns of 3–5 (firm to hard) were suspected to have a malignant nature. Sonographic-guided aspiration cytology took place in 107 lymph nodes and excisional biopsy in 102 lymph nodes, whereas 13 lymph nodes responded adequately to conservative treatment. They proved to be benign reactive hyperplasia. The majority of LNs (87%) were of the malignant type that showed an elastographic pattern of 3–5. The same patterns were observed in only 6 (3.4%) of the benign LNs. Sonoelastography showed a sensitivity of 85.9%, specificity of 100%, PPV of 100%, NPV of 75.96%, and overall accuracy of 90.23% in distinguishing benign from malignant lymph nodes. Using the B-Mode ultrasound, an abnormal hilum was seen in 75%. The accuracy of color Doppler US reached 82.7%. Sonoelastography may be superior to other US modalities in elucidating different cervical lymph node biopsy helping to distinguish benign from malignant lesions. This may replace the lymph node biopsies in the future. Moreover, its use in the follow-up of patients with cervical malignancies may reduce the number of future biopsies. Further studies with more patients may be needed for a better assessment of results. |
| Databáze: | OpenAIRE |
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