Value of combined real time sonoelastography and apparent diffusion coefficient value measurement in differentiation of enlarged neck lymph nodes

PurposeTo evaluate the role of real-time sonoelastography (UE) and apparent diffusion coefficient (ADC) value measurement in differentiating benign versus malignant enlarged neck lymph nodes.Materials and methodsThis study included 26 patients presented with 32 enlarged neck lymph nodes (LNs), underwent real-time UE and diffusion weighted MRI (DWI). ADC maps are generated from DWI and ADC values were calculated. Both UE and ADC findings were compared with histopathological results.ResultsThe LNs were 12 benign lymphadenopathy (37.5%, seen in 10 patients), 10 metastatic (31.25% seen in 8 patients) and 10 lymphoma (31.25%, seen in 8 patients) including 4 LNs with Hodgkin’s lymphoma (HL, seen in 3 patients) and 6 LNs with non Hodgkin’s lymphoma (NHL, seen in 5 patients). On UE 10 of the 12 benign LNs had pattern of 1–2 (83.3%) and 18 of 20 neoplastic LNs (90%) had pattern of 4–5. The mean ADC values of the benign, metastases and lymphoma groups were 1.52 ± 0.37, 0.90 ± 0.15 and 0.72 ± 0.12 × 10−3 (mm2/s), respectively.ConclusionCombined real-time UE and ADC value measurement are non invasive techniques useful for differentiation of enlarged neck lymph. The combination potentially could reduce unnecessary biopsy especially for elasticity pattern 1–2.