title: Evaluation of the sonographic features of metastatic cervical lymph nodes in patients with head and neck malignancy.
abstract: OBJECTIVE
  The aim of the study was to evaluate the sonographic findings of metastatic cervical lymph nodes and of differentiating them from benign ones in patients with head and neck malignancy.
  
  
  METHODS
  In this study, the cervical lymph nodes of 14 patients (12 female and 2 male patients; mean age, 52.8 years (with head and neck region malignancy were evaluated ultrasonographically. The gray-scale sonographic parameters, which included short- and long-axis lengths, shape index, presence or absence of hilar echoes and cystic necrosis, parenchymal echogenicity and echo texture, margin, and the color Doppler parameter including vascular pattern were evaluated. Finally, sonographic findings were compared with pathologic results. The following statistical analyses were included: χ(2) test, Fisher exact test, and independent-samples t-test.
  
  
  RESULTS
  Overall, 88 cervical lymph nodes were evaluated ultrasonographically. According to the histopathologic results, 77% of them were benign, and 23% were malignant. The study's results showed that the metastatic lymph nodes are accompanied with significantly larger size, rounded shape, absence of hilus, and presence of cystic necrosis and mixed and peripheral vascular pattern. The parameters related to minimal and maximal axis diameter had the highest sensitivity (85%), whereas 2 parameters of vascularity pattern and cystic necrosis had 100% specificity in detecting metastatic cervical lymph nodes.
  
  
  CONCLUSIONS
  The results of our study revealed that there was a considerable difference in the diagnostic value of the sonographic parameters, in differentiating metastatic lymph nodes from benign ones, between 4 specific neck regions.
authors.affiliation: Faculty of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahrokh
authors.initials: M
authors.lastname: Imani Moghaddam
authors.forename: Behrooz
authors.initials: B
authors.lastname: Davachi
authors.forename: Leila Vazifeh
authors.initials: LV
authors.lastname: Mostaan
authors.forename: Adineh Javadian
authors.initials: AJ
authors.lastname: Langaroodi
authors.forename: Bahram
authors.initials: B
authors.lastname: Memar
authors.forename: Sajad Ataei
authors.initials: SA
authors.lastname: Azimi
authors.forename: Parviz
authors.initials: P
authors.lastname: Marouzi
mesh_terms: D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D016012:Poisson Distribution; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler