Evaluation of Reliability of Ultrasonographic Parameters in Differentiating Benign and Metastatic Cervical Group of Lymph Nodes

Abstract

The aim of the current study is to determine the efficacy of ultrasound in differentiating between benign and metastatic group of cervical lymph nodes. The study included forty-five subjects who were divided into three groups with 15 in each, by stratified random sampling method. Group 1 comprised fifteen patients without signs and symptoms of any infection and neoplasms in head and neck region (control group). Group 2 included fifteen patients with signs and symptoms of malignancy in head and neck region. Group 3 consisted of fifteen patients with signs and symptoms of odontogenic infections. “MY LAB-40” ultrasound machine with linear array transducer of 7.5 MHZ frequency was used for detecting cervical lymph nodes following Hajek's classification. The patients further underwent ultrasound guided FNAC under standard aseptic protocol and samples were subjected to cytopathological evaluation. Chi square analysis and one way ANOVA test were applied to obtain the results. We concluded that ultrasound and USG FNAC can be used accurately to assess the status of lymph nodes. The ultrasonographic features of lymph nodes with round shape, absence of hilar echo, sharp nodal borders, hyperechoic internal echogenicity, and presence of intranodal necrosis were highly suggestive of metastatic cervical lymph nodes.

Is Acoustic Radiation Force Impulse (ARFI) Ultrasound Elastography Valuable in the Assessment of Cervical Lymphadenopathy?

“…Majority of the benign lymph nodes showed homogenous echopattern, short axis/long axis diameter ratio \ 0.5, presence of fatty hilum, well-defined margins and central or hilar vascular flow pattern. Our findings were consistent with recent studies [9].…”

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 .…”

“…Th e diagnostic power of the latter most likely refl ects its synthetic nature, by cumulating the information on morphological alterations across the score of individual predictors: as a proof of concept, 98% of the cytologically malignant LNs showed at least one morphological alteration. Th e level of expertise, learning curves and institutional settings may all aff ect this process; however, demographics, prior history of malignancy, cancer type and pre-treatment versus post-treatment evaluation probably also account for diff erent numbers of false-positive and false-negative results across the studies 20,26,33,37 . In support, a higher proportion of false positives, a measure of over-interpretation, was observed for suspicious LNs among women; in addition, some evidence for prior cancer history marginally aff ecting subjective suspicion was also noted.…”

An Inventory of Current Available Ultrasound Devices for Dental Use

“…They used an Esaote MyLab-40 ® ultrasound machine and a 7.5 MHz linear transducer to make qualitative observations of cervical lymph nodes including lymph node size, shape, and nodal borders (sharp or smooth), hypoechoic or hyperechoic lymph node characteristics and the presence of necrotic tissues in the nodes. They found that examining the qualitatively results from ultrasonography had high sensitivity and specificity in differentiating the various stages of reactivity of lymph nodes [21]. …”