Differentiation of benign and malignant cervical lymph nodes: value of B-mode and color Doppler sonography.
OBJECTIVE
To evaluate the efficacy of color Doppler sonography in detecting possible differences in blood flow patterns and B-mode sonographic characteristics between malignant and benign cervical lymph nodes.


METHODS
During a period of 10 months, the palpable cervical lymph nodes of 39 patients were prospectively evaluated with B-mode and color Doppler sonography. The echogenity, contour, ratio of longitudinal diameter to the transverse diameter and the presence of a hilus were evaluated by B-mode sonography. Capsullary and intranodal arterial flow rates were measured and maximal systolic, end-diastolic, mid-systolic flow velocities with pulsatility, resistivity and acceleration indices were obtained. Final diagnosis was established by excisional biopsy (n:34) and clinical follow-up (n:5).


RESULTS
The lymph nodes in 20 cases were malignant and in 19 cases were benign. The B-mode contour characteristics and presence of a hilus in malignant and benign lymph nodes were statistically significant (P < 0.05), but there were no significant differences between the ratio of longitudinal diameter to the transverse diameter (P > 0.05), echogenity (P > 0.05) and the diameters of lymph nodes (P > 0.05). Flow patterns were obtained in 14 malignant (70%) and 10 benign (52.6%) cases. The maximal systolic, end diastolic, mid-systolic flow velocities and pulsatility, resistivity, acceleration indices did not differ statistically (P > 0.05).


CONCLUSIONS
In the differentiations of benign and malignant cervical lymph nodes, the B-mode and color Doppler sonography are limited methods and can not replace biopsy.
Adibelli
Z H
ZH
Radiology Clinic, SSK Izmir Educational Hospital, Turkey.
Unal
G
G
Gül
E
E
Uslu
F
F
Koçak
U
U
Abali
Y
Y
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000098:blood supply / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009333:Neck; D011446:Prospective Studies; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color