title: Differentiation of benign and malignant cervical lymph nodes: value of B-mode and color Doppler sonography.
abstract: 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.
authors.affiliation: Radiology Clinic, SSK Izmir Educational Hospital, Turkey.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Adibelli
authors.forename: G
authors.initials: G
authors.lastname: Unal
authors.forename: E
authors.initials: E
authors.lastname: Gül
authors.forename: F
authors.initials: F
authors.lastname: Uslu
authors.forename: U
authors.initials: U
authors.lastname: Koçak
authors.forename: Y
authors.initials: Y
authors.lastname: Abali
mesh_terms: 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