Value of conventional ultrasound and shear‑wave elastography in the assessment of mesenteric lymphadenitis in a paediatric population

Abstract

The present retrospective study was designed to explore the value of conventional ultrasound (US) and Virtual Touch Tissue Imaging and Quantification (VTIQ) in the assessment of mesenteric lymphadenitis (ML) in a paediatric population. A total of 103 patients with ML and 60 healthy paediatric patients were examined. VTIQ was performed to assess mesenteric lymph node (MLN) stiffness via shear-wave velocity (SWV). Univariate and multivariate logistic regression analyses were conducted to reveal independent variables for the identification of ML. The diagnostic performance of US, and US combined with VTIQ, were compared. All the quantitative VTIQ parameters (including the SWV_Mean, SWV_Max and SWV_Min) were significantly greater for MLNs in the control group than for MLNs in the ML group (all P<0.001). The SWV values in the control group were nearly 2-fold greater than that in the ML group. According to the multivariate logistic regression analysis, the longest diameter [odds ratio (OR)=6.042; P=0.046] was revealed to be the strongest independent predictor for ML, followed by the CRP level (OR=2.310; P<0.001) and the SWV_Mean (OR=0.106; P<0.001). According to the receiver operating characteristic analysis, the area under the curve (AUC) for US combined with VTIQ was 0.890 (95% CI: 0.831-0.949) with a greater sensitivity of 91.26% and a greater specificity of 86.67% than that for US alone (AUC: 0.798; 95% CI: 0.724-0.872; sensitivity: 79.61%; specificity: 80.00%). A significant negative correlation between increased VTIQ parameters and ML was observed. Utilizing VTIQ to assess MLN stiffness offers a non-invasive, convenient, reliable and reproducible approach for identifying mesenteric lymphadenopathy.

Keywords: elasticity imaging techniques; hospitals; lymph nodes; paediatric; ultrasonography.

Figure 1

Participant selection process.

Figure 2

Box plots of SWV_Max, SWV_Mean and SWV_Min values in both the mesenteric lymphadenitis group and the control group. SWV, shear-wave velocity.

Figure 3

Ultrasound and Virtual Touch imaging and quantification of a 9-year-old female paediatric patient in the ML group. (A) B-mode ultrasound revealing a hypo-echogenic, L/S <1 lymph node. (B) Virtual Touch imaging quantification revealed that the SWVMax, SWVMin and SWVMean of the node was 2.49, 1.80 and 2.00 m/sec, respectively. SWV, shear-wave velocity; SWVMax, SWV; SWVMin, minimum SWV; SWVMean, average SWV.

Figure 4

Ultrasound and Virtual Touch imaging and quantification of a 6-year-old female paediatric patient in the ML group. (A) B-mode ultrasound revealing a hypo-echogenic, L/S <1 lymph node. (B) Virtual Touch imaging quantification revealed that the SWVMax, SWVMin and SWVMean of the node was 2.35, 1.74 and 1.96 m/sec, respectively. SWV, shear-wave velocity; SWVMax, maximum SWV; SWVMin, minimum SWV; SWVMean, average SWV.

Figure 5

Ultrasound and Virtual Touch imaging and quantification of a 6-year-old male paediatric patient in the control group. (A) B-mode ultrasound revealing a hypo-echogenic, L/S <1 lymph node. (B) Virtual Touch imaging quantification revealed that the SWV_Max, SWV_Min and SWV_Mean of the node was 2.52, 2.16 and 2.31 m/sec, respectively. SWV, shear-wave velocity; SWV_Max, maximum SWV; SWV_Min, minimum SWV; SWV_Mean, average SWV.

Figure 6

Ultrasound and Virtual Touch imaging and quantification of a 4-year-old female paediatric patient in the control group. (A) B-mode ultrasound revealing a hypo-echogenic, L/S <1 lymph node. (B) Virtual Touch imaging quantification revealed that the SWV_Max, SWV_Min, and SWV_Mean of the node was 2.99, 2.26 and 2.51 m/sec, respectively. SWV, shear-wave velocity; SWV_Max, maximum SWV; SWV_Min, minimum SWV; SWV_Mean, average SWV.