• Medicina clinica · Jan 2020

    Endobronchial ultrasound elastography for diagnosing mediastinal and hilar lymph nodes.

    • María Hernández Roca, Javier Pérez Pallarés, María Del Mar Valdivia Salas, José García Solano, David Prieto Merino, Juan José Martínez Díaz, and Antonio Santa Cruz Siminiani.
    • Hospital General Universitario Rafael Méndez, Lorca, Murcia, España; Health Sciences PhD program, Universidad Católica de Murcia UCAM, Guadalupe, Murcia, España. Electronic address: mariahernandezroca@gmail.com.
    • Med Clin (Barc). 2020 Jan 24; 154 (2): 45-51.

    IntroductionThe main objective was to analyze the technical variability of EBUS-elastography in the differentiation of benign and malignant hilar and mediastinal lymph nodes. As a secondary objective, the results of the EBUS-elastography in said differentiation were analyzed, comparing them with the anatomopathological results.Material And MethodsProspective and analytical study of lymph nodes in which EBUS-elastography was performed. Elastographic variables and their variability were analyzed.Results24 patients and 38 lymph nodes were evaluated. Of these, 60.5% had a history of neoplasia, 71% of them were EBUS-elastography with diagnostic intention, 53% were mediastinal staging of lung cancer. Both procedures were performed in 25% of the patients. Lymph nodes were classified into elastographic colour patterns, red being characteristic of elastic tissues and blue of rigid tissues. The lymphadenopathies with apredominantly blue pattern were associated with an anatomopathological result of malignancy (86% vs. 14%, OR 20.4 (3.1 -245.1) p-value = .00015). Malignant lymph nodes presented less colour dispersion in the frequency histograms and a higher ratio of blue pixels and higher strain ratio. These variables showed a variability of 8.7, 9.9 and 31.6% respectively in repetitions in the same adenopathy. Finally, a 66% of consistency was obtained in the event of colour pattern variability (p .0000).ConclusionsEBUS-elastography is feasible during EBUS and may be helpful in predicting malignant lymph node infiltration. The quantitative elastographic data show low variability in repetitions in the same adenopathy. The strain ratio is the most variable elastographic parameter.Copyright © 2019 Elsevier España, S.L.U. All rights reserved.

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