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High-frequency Ultrasound Imaging of Mouse Cervical Lymph Nodes
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Reliability of sonoelastography in predicting pediatric cervical lymph node malignancy.

Ossama M Zakaria1,2, Ahmed Mousa3,4, Reema AlSadhan3

  • 1Departments of Pediatric Surgery, Surgery, Radiology, Pathology, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. ossamaz2004@gmail.com.

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Summary

Sonoelastography accurately distinguishes benign from malignant pediatric cervical lymphadenopathy. This ultrasound technique shows high sensitivity and specificity, potentially reducing the need for invasive biopsies in children.

Keywords:
FNACLymph nodeLymphomaMalignancySonoelastography

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Area of Science:

  • Pediatric Radiology
  • Diagnostic Ultrasound
  • Oncology

Background:

  • Cervical lymphadenopathy is common in children, with accurate diagnosis crucial for appropriate management.
  • Non-invasive diagnostic tools are sought to avoid unnecessary invasive procedures like biopsies.
  • Sonoelastography offers a novel approach to assess tissue stiffness, aiding in differentiating benign from malignant lesions.

Purpose of the Study:

  • To evaluate the diagnostic performance of sonoelastography in pediatric cervical lymphadenopathy.
  • To determine the sensitivity, specificity, and accuracy of sonoelastography in distinguishing benign from malignant lymph nodes in children.
  • To compare sonoelastography with conventional ultrasound (B-mode and Color Doppler) for this diagnostic purpose.

Main Methods:

  • A prospective study included 128 children (177 lymph nodes) aged 11 months to 12 years.
  • Patients underwent B-mode sonography, Color Doppler ultrasound, and sonoelastography.
  • Diagnostic confirmation was obtained through sonographic-guided aspiration cytology or excisional biopsy, with some cases managed conservatively.

Main Results:

  • Sonoelastography demonstrated high diagnostic accuracy (90.23%) in differentiating benign from malignant pediatric cervical lymph nodes.
  • Sensitivity was 85.9%, specificity 100%, positive predictive value (PPV) 100%, and negative predictive value (NPV) 75.96%.
  • Malignant lymph nodes predominantly showed elastographic patterns of 3-5 (firm to hard), observed in 87% of cases, compared to only 3.4% of benign nodes.

Conclusions:

  • Sonoelastography is a reliable, non-invasive tool for diagnosing pediatric cervical lymphadenopathy.
  • It shows superior performance compared to B-mode and Color Doppler ultrasound in distinguishing benign from malignant lesions.
  • This technique may reduce the need for lymph node biopsies in children and aid in follow-up management.