title: Ultrasonographic and histopathological features of cervical lymph node metastases.
abstract: OBJECTIVE
  Different approaches have been made to differentiate benignant from malignant cervical lymphadenopathy using ultrasound examination. Assessment of nodal status is essential in patients with head and neck carcinomas as it predicts prognosis and helps in the selection of treatment options. The present study was designed to evaluate the role of ultrasound in the assessment of malignant cervical lymph nodes using the histological gold standard results. Gray-scale ultrasound assesses the nodal size, shape, border, internal architecture and color Doppler ultrasound evaluate the vascular pattern of lymph nodes.
  
  
  METHODS
  158 cervical lymphadenopathies evaluated by ultrasound in 100 patients over a period of 36 months (between January 2010 and December 2012) were evaluated for the presence of intranodal vascular pattern, which was considered benignant when it traversed through the node without disruption.
  
  
  RESULTS
  Of the 158 cervical tumors evaluated, 114 (72.2%) were found to be malignant on pathologic review. Malignant vascular markings were present in 133/158 lymph nodes evaluated. The presence of malignant vascular pattern had a sensitivity of 97.37% and a positive predictive value of 82.84%. Malignant gray-scale ultrasound markings had a sensitivity of 23.3% and a positive predictive value of 100%.
  
  
  CONCLUSIONS
  The presence of normal intranodal blood flow was associated with a benignant diagnosis in 87.5% of the masses evaluated. The addition of this color Doppler ultrasound finding improves the ability of ultrasound exam to predict the likelihood of malignant involvement.
authors: Department of Otolaryngology, University of Medicine and Pharmacy of Tirgu Mures, Romania; ionela_genes@yahoo.com.
authors: Ionela
authors: I
authors: Genes
authors: Carmen Aurelia
authors: CA
authors: Mogoantă
authors: Gabriel
authors: G
authors: Lostun
authors: Alexandra
authors: A
authors: Lostun
authors: Huba
authors: H
authors: Mózes
authors: Gheorghe
authors: G
authors: Műhlfay
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D055815:Young Adult