Diagnostic Accuracy of Combined B-Mode Ultrasound, Color Doppler and Strain Elastography in Assessment of Cervical and Axillary Lymph Nodes

Marwa Mostafa, Diagnostic Radiology and Medical Imaging Department, Faculty of Medicine-Mansoura University, Mansoura city, EgyptFollow
Nihal M. Batouty, Diagnostic Radiology and Medical Imaging Department, Faculty of Medicine-Mansoura University, Mansoura city, Egypt.
Amani Ezzat Mousa, Diagnostic Radiology and Medical Imaging Department, Faculty of Medicine-Mansoura University, Mansoura city, Egypt

Corresponding Author

Marwa Mostafa

Subject Area

Radiodiagnosis

Article Type

Original Study

Abstract

Background: Lymphadenopathy is a common condition caused by many benign and malignant disorders; therefore, determining their nature is important in clinical setting. The objective of research is to assess diagnostic accuracy of B-mode ultrasound, color Doppler, and strain elastography in lymph nodes evaluation with pathological correlation and to determine cut-off value of strain ratio that differentiates benign from malignant nodes.

Methods: All patients underwent ultrasound examination, Doppler study and strain elastography in supine position using a high-frequency probe (6.2-12 MHz). Out of 80 enrolled patients, only 53 were subjected to biopsy from the lymph nodes, then their pathological results were referred on the data system and analyzed.

Results: Benign lymph nodes were seen in (43.1%) of the nodes, while malignant ones were (56.9%). Both short axis diameter and border were the only features that show statistical significance (P = 0.024 and 0.031, in that order). The short axis cut-off point about 11.1 mm, while strain ratio cut-off point of 3.2 showed discrimination between malignant and benign nodes, with sensitivity (82.8%). Doppler ultrasound demonstrated the highest specificity (86.36%) in individual and combined modes. Combined B-mode and strain elastography achieved the highest overall accuracy (86.94%, AUC = 0.906), while combining all modes yielded the highest sensitivity (93.1%).

Conclusion: The present study confirms that; most individual sonographic criteria demonstrate overlap between benign and malignant lymph nodes. Strains ratio provided superior diagnostic performance, supporting its role as a complementary tool rather than a standalone technique. Finally, multi-modal ultrasound approach can raise the diagnostic accuracy.

Recommended Citation

Mostafa, Marwa; Batouty, Nihal M.; and Mousa, Amani Ezzat (2026) "Diagnostic Accuracy of Combined B-Mode Ultrasound, Color Doppler and Strain Elastography in Assessment of Cervical and Axillary Lymph Nodes," Mansoura Medical Journal: Vol. 56 : Iss. 1 , Article 11.
Available at: https://doi.org/10.58775/2735-3990.1594