Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy

Abstract

Background:To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign and malignant cervical lymph nodes by detecting differences in blood flow patterns.Materials and Methods:In this cross-sectional prospective study, 25 untreated patients with clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were the key CDUS features used to differentiate between reactive and metastatic lymph nodes. Histopathological confirmations were obtained and compared with the results of CDUS.Results:Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty-seven additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler features are used to differentiate benign and malignant nodes.Conclusion:Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.

Measurable and Unmeasurable Features of Ultrasound Lymph Node Images in Detection of Malignant Infiltration

“…Th e long-axis and the short-axis diameters were increased in malignantly altered LNs by FNAC. Similar fi ndings have been previously reported for malignant cervical LNs 19,20 . By contrast, although malignant LNs are usually larger than reactive ones, the reactive LNs can also be as large 21 .…”

“…Diff erent studies used diff erent cut-off values for the short-axis diameter in order to better distinguish malignant from benign nodes. It has also been argued that a higher cut-off value reduces the sensitivity but increases the specifi city, and vice versa 4,5,19,22,23 . In addition, regional variations and agedependent histoarchitectural changes in human LNs have also been described.…”

Utility of ultrasound elastography to differentiate benign from malignant cervical lymph nodes

“…and several other authors who have noted significant difference in vascularity between benign and malignant LNs. [ 13 26 ] In our study, the accuracy of vascularity of LN in predicting malignancy was 70%.…”

Дифференциальная Диагностика Изменений В Регионарных Лимфатических Узлах У Больных Меланомой Кожи При Ультразвуковом Исследовании

“…При этом отношение продольной оси ЛУ к поперечной (индекс Solbiati; L/T) составляет менее 2. Аналогичные данные приводят и другие исследователи [12,13,18,[20][21][22].…”

“…Кроме того, биопсия сторожевого ЛУ дает сведения об одном ЛУ в одной зоне. Пальпация, основываясь на косвенных признаках вовлечения регионарных ЛУ в патологический процесс, характеризуется низкими показателями диагностической эффективности и, по данным литературы [12][13][14][15], дает до 44% ложно-отрицательных и ложно-положительных результатов.…”