DIAGNOSTIC VALUE OF CONVENTIONAL AND CONTRAST-ENHANCED ULTRASOUND IN CERVICAL LYMPH NODE ASSESSMENT: APPLICATIONS IN SPORTS MEDICINE AND ATHLETE HEALTH MONITORING

Abstract

Objective: To evaluate the diagnostic accuracy of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) in distinguishing benign from malignant cervical lymph node diseases, with potential applications in sports medicine for monitoring athletes' health. Methods: A total of 120 patients with abnormal cervical lymph nodes treated at Wuhan Pulmonary Hospital from January 2022 to March 2023 underwent conventional ultrasound and CEUS examinations. Pathological results were used as the "gold standard" for comparison. Diagnostic performance indicators, including sensitivity, specificity, and accuracy, were assessed for conventional ultrasound, CEUS, and their combined application. Results: Among 122 pathologically confirmed lymph nodes, 40 were malignant (30 metastatic lymph nodes, 10 lymphomas), and 82 were benign (57 reactive hyperplasia, 20 tuberculosis, and 5 necrotizing lymphadenitis). Malignant lymph nodes showed significantly higher rates of L/S ratio <2, irregular morphology, disrupted lymphatic portal structures, cortical hypoechoic areas, mixed blood flow, and CEUS-specific perfusion patterns (P<0.05). The time-to-peak (TTP) was shorter, while peak intensity (PI) and descending slope (K) were higher in malignant nodes compared to benign ones (P<0.05). Combined ultrasound and CEUS demonstrated higher sensitivity (92.50%), specificity (81.71%), and accuracy (85.25%) than conventional ultrasound alone (75.00%, 52.44%, and 59.84%, respectively, P<0.05). Conclusions: Combining conventional ultrasound with CEUS improves diagnostic accuracy, sensitivity, and specificity in distinguishing malignant from benign cervical lymph nodes. This approach has promising applications in sports medicine, enabling early detection and management of cervical lymphatic abnormalities in athletes, supporting their health, and optimizing performance.