title: Evaluation of the efficacy of colour Doppler ultrasound in diagnosis of cervical lymphadenopathy.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the efficacy of colour Doppler ultrasound (CDUS) to differentiate between benign and malignant cervical lymph nodes.
  
  
  METHODS
  During a period of 12 months, 100 untreated patients with clinical evidence of cervical lymphadenopathy (50 patients with clinically suspected malignant/metastatic cervical lymphadenopathy and 50 patients with clinically suspected reactive/benign cervical lymphadenopathy) were prospectively evaluated with CDUS. CDUS was performed for 168 cervical lymph nodes in these 100 patients. Histopathological confirmations were obtained by fine needle aspiration biopsy and/or excisional biopsy. To evaluate the efficacy of CDUS, comparison between clinical features, CDUS features and cytological/histological features of enlarged cervical lymph nodes was then done.
  
  
  RESULTS
  Initially, clinical examination evaluated 143 cervical lymph nodes. CDUS evaluation discovered additional 25 lymph nodes (143+25 = 168). Correlation of patterns of colour Doppler flow signals with pathological diagnosis showed that central flow for benign nodes and peripheral flow for malignant nodes were highly significant parameters (P < 0.01). CDUS has a higher specificity than clinical evaluation, being 94.28% and 58.76%, respectively. Accuracy of the CDUS examination was also definitely higher than clinical evaluation at 92.85% and 63.67%, respectively.
  
  
  CONCLUSIONS
  Nodal vascularity can be used to differentiate benign from malignant lymphadenopathy. Proper judicious CDUS examination provides an opportunity to eliminate the need for biopsy/FNAC in reactive nodes.
authors.affiliation: Department of Oral Medicine and Radiology, DMIMS, Sawangi (M), Wardha, Maharashtra 442004, India. dangore_suwarna@rediffmail.com
authors.forename: S B
authors.initials: SB
authors.lastname: Dangore
authors.forename: S S
authors.initials: SS
authors.lastname: Degwekar
authors.forename: R R
authors.initials: RR
authors.lastname: Bhowate
mesh_terms: D001706:Biopsy; D044963:Biopsy, Fine-Needle; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D008199:Lymphadenitis / Q000000981:diagnostic imaging / Q000473:pathology; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging; D009382:Neoplasms, Unknown Primary / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology; D018615:Ultrasonography, Doppler, Color / Q000706:statistics & numerical data; D014655:Vascular Resistance / Q000502:physiology