Diagnostic Value Of Contrast-enhanced Ultrasound In Cervical Lymph Node Metastasis From Oral And Maxillofacial Squamous Cell Carcinoma

Objective: To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)for cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma.Methods: Forty-one patients with oral and maxillofacial squamous cell carcinoma who underwent surgery and neck dissection,and all patients were examined preoperatively with both conventional ultrasound and CEUS.The postoperative pathological diagnosis was used to divide the metastatic and non-metastatic groups,the differences in conventional ultrasound and CEUS imaging characteristics of lymph nodes between the two groups were evaluated and multifactorial logistic regression models were used to analyze the risk factors associated with metastatic lymph nodes.The ROC curve was used to evaluate the diagnostic value of the two methods alone or in combination for cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma.SPSS 25.0 software was used for statistical analysis of the data.Results: Twenty-nine metastatic lymph nodes and 28 non-metastatic lymph nodes were pathologically diagnosed.Conventional ultrasound in the metastatic group showed L/S≤2,irregular morphology,abnormal lymphatic hilum,inhomogeneous echo inside,and peripheral or mixed blood flow,which were statistically different from the non-metastatic group(P <0.05).The difference in perfusion pattern and perfusion type between the metastatic and non-metastatic groups was statistically significant(P < 0.05).Conventional ultrasound showed irregular morphology,abnormal lymphatic hilum,inhomogeneous echo inside,peripheral type or mixed blood flow;CEUS showed centripetal or mixed type,inhomogeneous enhancement with irregular perfusion defect type or faint enhancement type were associated risk factors for metastatic lymph nodes(P < 0.05).The sensitivity of conventional ultrasound,CEUS and in combination for the diagnosis of cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma was 65.5%,79.3%and 82.8%,respectively;the specificity was 71.4%,82.1% and 67.9%,respectively;the positive predictive value was 70.4%,82.1% and 72.7%,respectively;the negative predictive value was 66.7%,79.3% and 79.2%,respectively;and the area under the ROC curve was 0.685,0.807 and 0.753,respectively.Conclusion: CEUS is more effective than conventional ultrasound in the diagnosis of cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma,and has certain clinical application value.