Evaluation of the efficacy of colour Doppler ultrasound in diagnosis of cervical lymphadenopathy.
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.
Dangore
S B
SB
Department of Oral Medicine and Radiology, DMIMS, Sawangi (M), Wardha, Maharashtra 442004, India. dangore_suwarna@rediffmail.com
Degwekar
S S
SS
Bhowate
R R
RR
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