The role of gray scale ultrasound and elastography in differentiating benign and malignant axillary lymph nodes

Abstract

Axillaries lymph node status is an important prognostic factor in breast cancer. Non-invasive imaging methods are used to examine the lymph node status of the Axillaries guardian before surgery. Due to the differing sensitivity and specificity of these methods, the purpose of this study is to determine the diagnostic value of gray scale ultrasound and elastography in differentiating the benign and malignant Axillaries nodes. Materials and Methods: The present study is descriptive-analytic. In this study, In this study, patients referring to Imam Reza Hospital in Tabriz for ultrasonography and and in lymphatic ultrasonography, suspected nodes needed additional examination and variables such as Short-axis diameter, Long / short-axis ratio, Hilum and Cortical thickening were investigated and in that benign and malignant lymph node was also evaluated. Then elastography was performed. In elastography, the elastographic parameters of the lesions were evaluated with this device and the lesions were taken as soft (benign) and hard (malignant). Subsequently, patients underwent surgical dysplasia under needle biopsy. Finally, the results of gray scale ultrasound and elastography and pathology findings were entered into the checklist and all data were analyzed using SPSS v19 software for analysis and data analysis. Results: This study was performed on 50 patients with breast mass and Axillaries lymphadenopathy. The mean age of the patients was 48.54 ± 10.58 years. 52% of the breast mass was on the right side and the most common pathology of breast carcinoma of the Intraductal Carcinoma (IDC) was 92%. 60% of the examined lymph nodes were malignant. 44% of patients had abnormal sonography findings. 60.71% of the removal of adipose tissue in lymphed nose and 42.85% increase in cortical thickness of lymph node with a mean thickness increase of 6.67 mm lymph node cortex. It was also observed that the ratio of the lowest diameter to the highest diameter of lymph nodes was 40.68% for benign pathology and 72.43% for malignant cases (P = 0.000). In elastography findings, 52% were hard and 48% were soft. Sensitivity and specificity of diagnostic modalities as well as gray scale ultrasound findings showed that sensitivity and specificity in gray scale ultrasound were 86.66% and 90%, in elastography 70 and 75%, and gray scale ultrasound and elastography combination was 86.66% and 65% Percentage. Conclusion: