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

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL Clinics Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI:10.1016/j.clinsp.2024.100541

Lin Li, Lan He, Minchao Xiong, Xiaoyan Wang

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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.

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超声造影联合血清降钙素原对结核性淋巴结及转移性淋巴结的诊断价值。

目的：探讨超声造影（CEUS）联合降钙素原（PCT）在鉴别结核性淋巴结（TLN）与转移性淋巴结（MLN）中的价值。方法：这项前瞻性队列研究包括207例连续诊断为CTL的患者。所有患者在病理或实验室确诊前均行常规超声和超声造影检查。采用酶联免疫吸附试验（ELISA）测定血清各项指标。采用多因素logistic回归进行预测建模。通过绘制受试者工作特征（ROC）曲线和校准曲线，并使用曲线下面积（AUC）和Hosmer-Lemeshow （H-L）检验来评估预测模型的诊断和校准性能。结果：207例患者中有102例（49.27%）经病理或实验室诊断为MLN，其中50.8%为TLN。超声造影显示，TLN常与动脉期同心增强（67.65% vs. 40.95%）和淋巴结非均匀增强模式（70.59% vs. 52.38%）相关。MLN患者病变的峰值强度（PI）较高。动脉期年龄增强的同心表现、PI升高和血清PCT大于5.39 ng/mL是MLN的独立危险因素。血清PCT联合超声造影预测模型对MLN有较高的诊断价值。H-L检验表明模型拟合满意（p < 0.05），校正曲线与理想对角线非常接近。结论：超声造影联合血清PCT对TLN和MLN的鉴别诊断有较好的临床应用价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.