Diagnostic value of contrast-enhanced ultrasound combined with serum procalcitonin in tuberculous lymph nodes and metastatic lymph nodes.

Clinics (Sao Paulo)

Department of Radiology, The People's Hospital of Zhaoyuan City, Zhaoyuan City, Shandong Province, PR China. Electronic address:

Published: December 2024

AI Article Synopsis

  • The study aimed to assess the effectiveness of Contrast-Enhanced Ultrasound (CEUS) along with Procalcitonin (PCT) levels in distinguishing Tuberculous Lymph Nodes (TLN) from Metastatic Lymph Nodes (MLN) in 207 patients.
  • Results showed significant differences in imaging patterns, with TLN exhibiting specific enhancements that were less common in MLN, and higher PCT levels indicating a higher risk for MLN.
  • The combination of CEUS and PCT provided a more accurate predictive model for diagnosing MLN, demonstrating good calibration and diagnostic performance.

Article Abstract

Objective: To investigate the value of Contrast-Enhanced Ultrasound (CEUS) combined with Procalcitonin (PCT) in differentiating Tuberculous Lymph Nodes (TLN) from Metastatic Lymph Nodes (MLN).

Methods: This prospective cohort study included 207 consecutive patients diagnosed with CTL. All patients underwent routine ultrasound and CEUS prior to pathology or laboratory confirmation. Serum indicators were measured by Enzyme-Linked Immunosorbent Assay (ELISA). Predictive modeling was performed by multifactorial logistic regression. Evaluate the diagnostic and calibration performance of the predictive model by drawing Receiver Operating Characteristic (ROC) curves and calibration curves, and using Area Under the Curve (AUC) and Hosmer-Lemeshow (H-L) tests.

Results: The diagnosis of MLN was confirmed pathologically or laboratory in 102 of 207 patients (49.27 %), and 50.8 % were confirmed to be TLN. According to imaging findings of CEUS, TLN was more commonly associated with enhanced concentric performance in the arterial phase (67.65 % vs. 40.95 %) and heterogeneous enhancement pattern in lymph nodes (70.59 % vs. 52.38 %). Peak Intensity (PI) of lesions was higher in patients with MLN. Increased age-enhanced concentric performance in the arterial phase, increased PI, and serum PCT greater than 5.39 ng/mL were independent risk factors for MLN. The prediction model of serum PCT combined with CEUS had a higher diagnostic value for MLN. The H-L test indicated a satisfactory model fit (all p > 0.05), and the calibration curve closely approximates the ideal diagonal.

Conclusion: CEUS combined with serum PCT has better clinical application value in the differential diagnosis of TLN and MLN.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clinsp.2024.100541DOI Listing

Publication Analysis

Top Keywords

lymph nodes
20
serum pct
12
contrast-enhanced ultrasound
8
combined serum
8
tuberculous lymph
8
metastatic lymph
8
ultrasound ceus
8
ceus combined
8
concentric performance
8
performance arterial
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!