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頸部リンパ節症の病変の特性評価における歪みおよびせん断波エラストグラフィの比較評価

Anil Rawat¹, Siddharth Mishra², Nitin Arun Dikshit¹

¹Department of Radiodiagnosis, King George's Medical University, Lucknow, IND.

|February 2, 2026

Insights

歪みエラストグラフィおよびせん断波エラストグラフィ（SWE）は、良性および悪性の頸部リンパ節を正確に区別します。これらの高度な超音波技術は、侵襲的な診断処置の必要性を減らすことができます。

科学分野:

医用画像診断; 診断用超音波検査; 腫瘍学

背景:

頸部リンパ節症の診断は、針吸引細胞診および組織病理学などの侵襲的な方法に依存しています。; 従来の超音波検査は、良性および悪性のリンパ節を区別する上での特異性に限界があります。; 歪みエラストグラフィおよびせん断波エラストグラフィ（SWE）を含むエラストグラフィ技術は、悪性腫瘍の既知の指標である組織の硬さを評価します。

研究の目的:

良性および悪性の頸部リンパ節を区別する上での歪みエラストグラフィおよびSWEの有効性を評価すること。; 従来の超音波法とのエラストグラフィ技術の診断パフォーマンスを比較すること。

主な方法:

5歳から60歳までの患者の97個の頸部リンパ節を対象とした横断研究。; Bモード超音波、カラードップラー、歪み比、およびSWEを用いた評価。組織病理学/細胞診を基準標準としました。; 受信者操作特性（ROC）分析を用いて診断精度を決定しました。

主要な成果:

悪性リンパ節は、良性リンパ節（それぞれ9.23 kPaおよび1.18）と比較して、より高い平均弾性率（72.06 kPa）および歪み比（2.30）を示しました。; SWEは、カットオフ速度2.195 m/s（AUC = 0.940）で100％の感度と85％の特異度を示しました。; 歪み比は、カットオフ1.465（AUC = 0.956）で91.5％の感度と99％の特異度を達成しました。

結論:

従来の超音波検査と併用した場合、歪みエラストグラフィおよびSWEは、頸部リンパ節の病理診断において高い精度を提供します。; これらの非侵襲的なエラストグラフィ法は、侵襲的な診断処置の必要性を潜在的に減らすことができます。; エラストグラフィは、リンパ節の特性評価を改善するための貴重な定量的硬さ情報を提供します。

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要旨

Background:

Cervical lymphadenopathy has varied causes, from benign infections to malignancy. Accurate differentiation is crucial for staging and treatment. While fine needle aspiration cytology and histopathology are considered the gold standards, they are invasive procedures. Conventional ultrasound offers structural and vascular assessment but limited specificity. Elastography, including strain elastography and shear wave elastography (SWE), measures tissue stiffness, which is typically higher in malignancies.

Aim:

This study aimed to assess the role of strain and SWE in differentiating benign from malignant cervical lymph nodes.

Methods:

In this cross-sectional study at a tertiary care center, 97 cervical lymph nodes from patients aged 5-60 years were evaluated with B-mode ultrasound, color Doppler, strain ratio, and SWE. Histopathology/cytology served as the reference. Receiver operating characteristic analysis determined diagnostic performance.

Results:

Malignancy was associated with older age, female sex, levels II and IV, absent hilum, heterogeneous echotexture, and peripheral vascularity (t = -3.64, p = 0.001). Malignant nodes had higher mean elasticity (72.06 vs. 9.23 kPa) and strain ratio (2.30 vs. 1.18) (t = -3.64, p = 0.001). SWE velocity cutoff 2.195 m/s achieved 100% sensitivity and 85% specificity (area under the curve, AUC = 0.940). A strain ratio cutoff of 1.465 achieved 91.5% sensitivity and 99% specificity (AUC = 0.956).

Conclusion:

Strain and SWE, combined with conventional US, provide high accuracy in differentiating cervical lymph node pathology, thereby reducing the need for unnecessary invasive procedures.

キーワード:

頸部リンパ節症診断精度せん断波エラストグラフィ歪みエラストグラフィ超音波画像診断

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