1.Application of Multimodal Ultrasound in Diagnosis,Typing and Staging of Primary Nodal Diffuse Large B-Cell Lymphoma
Hongyan DENG ; Wenjuan LU ; Yasu ZHOU ; Ya YUAN ; Xinhua YE
Chinese Journal of Medical Imaging 2024;32(11):1111-1117
Purpose To investigate the application value in diagnosis,typing and staging of multimodal ultrasound in primary nodal diffuse large B-cell lymphoma(N-DLBCL).Materials and Methods A total of 96 patients(96 nodes)with a pathological diagnosis of N-DLBCL(51 nodes)or benign lymph nodes(45 nodes)in the First Affiliated Hospital of Nanjing Medical University from October 2020 to June 2022 were enrolled,retrospectively.All these patients were examined by high-frequency ultrasound,shear wave elastography(SWE)and contrast-enhanced ultrasonography(CEUS).The differences among the three ultrasound imaging methods in differentiating N-DLBCL from benign lymph nodes,typing and staging of N-DLBCL were analyzed.Receiver operating characteristic curve were drawn to obtain the diagnostic thresholds of SWE and CEUS quantitative indexes,and the efficacy of the different examination methods were assessed.Results Univariate analysis demonstrated 14 parameters were significantly different between the N-DLBCL and benign lymph nodes(χ2=12.289-32.934,all P<0.05).Multivariate analysis showed the difference in long diameter/short diameter(OR=11.205,P=0.012),cortical echo(OR=10.367,P=0.002),maximum elasticity(OR=0.180,P=0.014),peak time(OR=0.111,P=0.025),peak intensity-basic intensity(OR=0.061,P=0.002)and enhancement distribution(OR=0.065,P=0.001)were statistically significant between the two groups.There were statistically significant differences of maximum elasticity(χ2=5.299,P=0.021)between germinal center and non-germinal center N-DLBCL groups.There were statistically significant differences in blood flow pattern(χ2=9.663,P=0.017),arrival time(χ2=2.851,P=0.034)and peak time(χ2=6.702,P=0.018)between the limited and advanced N-DLBCL.The area under the curve for the diagnosis of N-DLBCL and benign lymph nodes by high-frequency ultrasound,SWE,CEUS and multimodal ultrasound were 0.754,0.839,0.875 and 0.963,respectively.Conclusion Multimodal ultrasound has high application value in differential diagnosis,classification and staging of N-DLBCL,and can provide basis for diagnosis and treatment of N-DLBCL.

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