| Summary: | Lung cancer remains one of the most common
malignant tumors. Identifying cervical lymph node metastases is important to
stage lung cancer, evaluate patients’ prognosis and select appropriate
treatments. This study evaluated the utility of conventional ultrasound combined
with contrast-enhanced ultrasound (CEUS) quantitative analysis in diagnosing lung
cancer metastases in the lymph nodes of the neck. The cervical lymph
nodes of 39 patients with primary lung cancer who underwent CEUS and
ultrasound-guided needle biopsy were assessed. Routine type B ultrasound was used
to record the morphology of the lymph nodes and the presence of lymphatic hilum
structure. The Vuebox quantitative analysis software was used to collect lymph
node CEUS peak enhancements (PE), rise time (RT) and fall time (FT). The receiver
operating characteristic (ROC) curve was used to evaluate the diagnostic value of
various parameters and imaging characteristics. The cohort comprised 26
cervical lymph nodes with lung cancer metastasis and 13 cervical lymph nodes with
reactive hyperplasia. Most hilum of lymph gland were absent in the metastasis
group (92.30%), most lymph nodes showed a full shape (80.77%), and few were
irregularly shaped (19.23%). Most hilum of lymph gland were present in the
hyperplasia group (76.95%) and showed a full shape (61.54%). The PE of the
metastasis group (4852.29 a.u) was significantly lower than the hyperplasia group
(11,464.70 a.u), while the difference between RT and FT indicators was not
significant. ROC analysis showed that combined PE of the quantitative ultrasound
contrast analysis and the presence of the lymphatic phylum structure showed
satisfactory diagnostic ability for detecting lung cancer lymph node metastasis
in the neck (sensitivity 73.10%, specificity 76.90%, accuracy 48.73%,
p = 0.004). Conventional ultrasound observation of lymph node
structure combined with quantitative analysis of peak enhancement of
contrast-enhanced ultrasound showed promising value for diagnosing lung cancer
metastatic lymph nodes.
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