Application of conventional and contrast-enhanced ultrasound in diagnosing cervical tuberculous lymphadenitis.

OBJECTIVE

To evaluate the predictive value of contrast-enhanced ultrasonography (CEUS) in differentiating cervical tuberculous lymphadenitis (CTL) from non-tuberculous cervical lymphadenitis (NCTL).

METHODS

A retrospective analysis was conducted on 303 patients with cervical lymphadenopathy. Various CEUS features, including the long axis diameter (L), short axis diameter (S), length-to-width ratio (L/S), presence of the hilum, boundary clarity, internal echogenicity, calcification, necrosis, blood flow distribution within the lymph node, and direction of blood flow, were examined. A multivariate logistic regression model was developed to predict CTL.

RESULTS

The model identified key predictive factors, including absent hilum, necrosis, heterogeneous enhancement, perfusion defects, peripheral ring enhancement, and non-centrifugal enhancement. In the training cohort (n = 202), the model achieved an AUC of 0.913, with high specificity (77.5%) and sensitivity (92.6%). Similar performance was observed in the validation cohort (n = 101, AUC = 0.917).

CONCLUSION

CEUS analysis demonstrates significant efficacy in distinguishing CTL from NCTL, thereby enhancing diagnostic accuracy.