Sonoelastographic evaluation for benign neck lymph nodes and parathyroid lesions

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Elastography

Background:

• Differentiating parathyroid lesions from benign neck lymph nodes can be challenging.
• Hashimoto thyroiditis affects thyroidal lymph nodes, necessitating accurate diagnostic tools.

Purpose of the Study:

• To evaluate the performance of real-time strain sonoelastography in comparing perithyroidal lymph nodes in Hashimoto thyroiditis patients, jugular lymph nodes in healthy individuals, and parathyroid lesions.
• To assess the utility of the elasticity score (E-index) in distinguishing these entities.

Main Methods:

• Ultrasound and real-time strain sonoelastography were performed on 95 patients.
• Three groups were studied: 50 parathyroid lesions, 52 lymph nodes in Hashimoto thyroiditis patients, and 51 reactive jugular lymph nodes.
• The elasticity score (E-index) was calculated for each lesion/node.

Main Results:

• Statistically significant differences in E-index were observed between the three groups (p < 0.01).
• Mean E-index values were 2.30 ± 0.91 for parathyroid lesions, 2.70 ± 0.93 for Hashimoto lymph nodes, and 1.88 ± 0.59 for jugular lymph nodes.
• Parathyroid hyperplasia was confirmed in 5% of patients with parathyroid lesions.

Conclusions:

• Strain sonoelastography, using E-index, provides valuable information for the differential diagnosis of parathyroid lesions and benign neck lymph nodes.
• This technique can enhance routine clinical practice for evaluating neck masses.