Role of Sonography in Evaluation of Cervical Lymph Nodes and Comparison With Their Cytological Findings

Abstract

). Ultrasound evaluation of cervical lymph-nodes was done using high frequency (7.5-MHz) linear transducer in 100 patients. Various Parameters such as size, shape (L/S ratio), hilar echogenicity, micro calcification, color flow pattern and R.I. (resistive index) were applied to assess the lymph nodes. Fine needle aspiration cytology of these lymph nodes was done under ultrasound guidance and sent for cytological evaluation. Finally results of ultrasound and cytology compared. In this study ultrasound examination of total 100 patients with subsequent F.N.A.C of cervical lymph node was done. Out of 100 pt 74 were having benign and 26 were having malignant etiology. In this study we found size criterion has sensitivity of 84.6%, specificity 67.5% PPV 47.8% NPV 92.5%.L/S ratio criterion has sensitivity 88.6%, specificity 75.6%, PPV 56.1%, and NPV 94.9%. Hilar echogenicity criterion has sensitivity 76%, specificity 82.4%, PPV 60.6%, NPV 91.9%. Using micro-calcification criterion we got sensitivity of 30.7%, specificity 97.2%, PPV 80%, NPV 80%. Peripheral vascularity criterion has sensitivity of 84.6%, specificity 70.2%, PPV 50 %and NPV 92.8%. Finally R.I. value has sensitivity 92.3% specificity 71.6% PPV 53% and NPV 96.3%. AIMS AND OBJECTIVES: Sonographic examination of cervical lymph nodes. To do FNAC of cervical lymph nodes. Comparison of ultrasound findings of cervical lymph node with Cytological findings. To assess sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound in diagnosing malignant and benign nature of cervical lymph node. The aim of this study is to evaluate the role of ultrasound in differentiation of normal/reactive nodes from malignant one. MATERIAL AND METHODS: This is a prospective study conducted in department of radio diagnosis, G.R. Medical College and JA groups of hospitals Gwalior using USG machine Aloka Pro sound Alpha-6 (Aloka Trivitron Pvt. Ltd. Tokyo Japan). Linear 7.5-MHz probe was used for real-time B-scans of the neck, during period of one year. All the patients sent for USG guided FNAC from cervical lymph nodes were scanned sonographically. All the patients send to radiological assessment of cervical lymph adenopathy were scanned sonographically and USG guided FNAC from lymph nodes were taken in selected patients. Total one hundred patients were examined and F.N.A.C of these patient's lymph node was done. Findings of ultrasound and cytology were compared.