Background/Objectives: Lymph node (LN) evaluation is critical in diagnosing, staging, and managing various diseases, particularly lymphoma and metastatic cancer. Although conventional ultrasound (US) is widely used for this purpose, its limitations in reliably differentiating between benign and malignant LNs persist. Ultrasound elastography (US-E), which evaluates tissue stiffness, has emerged as a promising adjunct to improve diagnostic accuracy. This study aims to evaluate the diagnostic performance of conventional US, power Doppler US, and strain elastography (SE) in distinguishing malignant from benign superficial lymph nodes. Methods: In this prospective study, 214 consecutive patients referred for US of enlarged LNs were enrolled. Conventional B-mode US, power Doppler, and SE were performed, and the strain ratio (SR) was calculated as a measure of LN stiffness. Histopathological examination was used as the reference standard. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis, and multivariable logistic regression models were applied to determine the independent predictive role of SR. Results: Among the 214 LNs (one for each patient), 74 (34.6%) were benign and 140 (65.4%) were malignant. The SR showed a significant association with malignancy (p< 0.001). For hematological malignancies, SR demonstrated high sensitivity (79–85%) and specificity (81–96%), with an overall area under the curve (AUC) of 0.91. Multivariable analysis confirmed that SR was an independent predictor of malignancy (continuous and dichotomous), with a 14% gain in predictive accuracy when treated as a continuous variable (p< 0.0001). Conclusions: US-E, particularly SR, is a valuable tool in the differentiation of benign and malignant superficial LNs. SR provides significant diagnostic value, especially in hematological neoplasms like Hodgkin lymphoma, and can serve as an independent predictor of malignancy. This technique, when used in combination with conventional US features, offers enhanced diagnostic performance for LN evaluation.
**背景/目的：** 淋巴结评估对于多种疾病，特别是淋巴瘤和转移癌的诊断、分期和管理至关重要。虽然传统超声已广泛用于此目的，但其在可靠区分良恶性淋巴结方面仍存在局限性。评估组织硬度的超声弹性成像作为一种有前景的辅助手段，有望提高诊断准确性。本研究旨在评估传统超声、能量多普勒超声及应变弹性成像在鉴别浅表良恶性淋巴结中的诊断效能。 **方法：** 在这项前瞻性研究中，连续纳入了214例因淋巴结肿大转诊进行超声检查的患者。对所有患者均进行传统B型超声、能量多普勒及应变弹性成像检查，并计算应变比作为淋巴结硬度的衡量指标。以组织病理学检查结果为金标准。采用受试者工作特征曲线分析评估诊断准确性，并应用多变量逻辑回归模型确定应变比的独立预测作用。 **结果：** 在214个淋巴结（每位患者一个）中，74个（34.6%）为良性，140个（65.4%）为恶性。应变比与恶性病变存在显著相关性（p < 0.001）。对于血液系统恶性肿瘤，应变比显示出较高的敏感性（79–85%）和特异性（81–96%），总体曲线下面积为0.91。多变量分析证实，应变比是恶性病变的独立预测因子（连续变量和二分类变量），当作为连续变量处理时，其预测准确性提高了14%（p < 0.0001）。 **结论：** 超声弹性成像，特别是应变比，是区分浅表良恶性淋巴结的有价值工具。应变比具有重要的诊断价值，尤其对于霍奇金淋巴瘤等血液系统肿瘤，可作为恶性病变的独立预测因子。该技术与传统超声特征结合使用，可提高淋巴结评估的诊断效能。
肿瘤(癌症)患者之家