Abstract
BACKGROUND: Lymph nodes are critical immune system components, filtering harmful substances and acting as indicators in various disease states, including cancer. Accurate differentiation between benign and malignant superficial lymph nodes is essential for diagnosis and treatment planning. However, conventional diagnostic methods often lack the required precision. High-frequency contrast-enhanced ultrasound (H-CEUS) offers improved temporal resolution and visualization of microvascular structures, potentially providing better diagnostic accuracy than standard contrast-enhanced ultrasound (CEUS). METHODS: This study included 77 patients with suspected abnormalities in superficial lymph nodes. Each patient underwent H-CEUS and CEUS examinations, with diagnoses confirmed through biopsy or surgical resection. The diagnostic performance of H-CEUS and CEUS was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Chi-square tests and ROC curve analysis were employed to compare the efficacy of H-CEUS and CEUS in differentiating benign from malignant lymph nodes. RESULTS: H-CEUS demonstrated superior diagnostic performance over CEUS, with higher sensitivity (95.92% vs. 83.67%), specificity (92.86% vs. 57.14%), and accuracy (94.80% vs. 74.03%). H-CEUS enhanced microvascular morphology visualization, facilitating more accurate differentiation between benign and metastatic lymph nodes. The area under the ROC curve for H-CEUS (0.944) was significantly greater than that for CEUS (0.704), indicating improved diagnostic capability. CONCLUSION: H-CEUS offers enhanced accuracy in diagnosing the nature of superficial lymph nodes, potentially improving clinical decision-making for patients with suspected lymph node malignancies. These findings support the integration of H-CEUS into routine clinical practice to achieve better diagnostic outcomes.