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Evaluation of Sonographic and Strain Elastographic Findings in Tubercular Cervical Lymphadenopathy

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Abstract

Purpose

Tuberculous cervical lymphdaenopathy is the most common manifestation of extrapulmonary tuberculosis and frequently present imaging diagnostic dilemma with metastatic lymphadenopathy. Ours is observational study done to describe the role of sonography including Doppler and strain elastography in tubercular cervical lymphadenopathy.

Methods

One hundred fine needle aspiration cytology/histopathological examination(FNAC/HPE) proven tubercular lymph nodes were evaluated with sonography and strain elastography. Features evaluated with sonography are location, size, short/long axis diameter (S/L) ratio, presence or absence of echogenic hilum, intra-nodal necrosis, intra-nodal calcification-associated soft tissue features like periadenitis, or collection and pattern of vascularity. With strain elastography (USE), color-coded elastograms and strain ratio were evaluated.

Results

On evaluation, tubercular nodes are large size; S/L ratio > 0.5 shows intra-nodal necrosis and peripheral vascular pattern. Ninety-one percent tuberculous lymph nodes had color-coded elastograms > 2 pattern which is similar to malignant lymph nodes and 99% of tuberculous lymph nodes show strain ratio < 1.99.

Conclusion

Grey scale and Doppler assessment of tubercular lymph nodes reveals findings similar to that encountered in metastatic nodes; hence, the differentiation is difficult, while strain ratio being semi-quantitative is more objective criteria of assessment compared to color-coded elastograms. Hence, adding semi-quantitative elastographic evaluation with ultrasound (US) will help in further characterization of tuberculous nodes.

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Code Availability

Analyzed data is included in the article. Dataset used for the current study is available with the corresponding author and available on request.

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Author information

Authors and Affiliations

  1. Department of Radiodiagnosis, VMMC & Safdarjung Hospital, RZ-6C, Gali No-30, Indira Park, Palam, New Delhi, 110045, India

    Renu Yadav & Amita Malik

  2. Pathology, C I O Lab, VMMC & Safdarjung Hospital, New Delhi, India

    Rajni Prasad

Authors
  1. Renu Yadav
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  2. Amita Malik
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  3. Rajni Prasad
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Contributions

Renu Yadav—data collection, interpretation, manuscript preparation, manuscript revision. Amita Malik—data interpretation, manuscript preparation, manuscript revision. Rajni Prasad performed the histopathological examination of FNAC/biopsy slides; manuscript preparation; and revision. Each author contributed substantially to the design of work. All authors have read and approval the final manuscript and take full accountability of work and data given.

Corresponding author

Correspondence to Renu Yadav.

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Ethics Approval and Consent to Participate

The study was approved by the ethical committee of Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi. India 110029 with approval number IEC/VMMC/SJH/Thesis/November -2014/411 Written informed consent was obtained from all study subjects before enrolling into study.

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Not applicable.

Competing Interests

The authors declare no competing interests.

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This article is part of the Topical Collection on Imaging.

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Yadav, R., Malik, A. & Prasad, R. Evaluation of Sonographic and Strain Elastographic Findings in Tubercular Cervical Lymphadenopathy. SN Compr. Clin. Med. 4, 114 (2022). https://doi.org/10.1007/s42399-022-01192-3

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  • DOI: https://doi.org/10.1007/s42399-022-01192-3

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