title: Predicting malignant neck lymphadenopathy using color duplex sonography based on multivariate analysis.
abstract: OBJECTIVE
  To select the best predictors of cervical lymph node malignancy based on gray-scale and power Doppler sonography using multivariate analysis.
  
  
  METHODS
  We evaluated sonographically a total of 97 lymph nodes in the neck that were subjected to fine-needle aspiration biopsy. The gray-scale and power Doppler sonography parameters that we analyzed using multivariate logistic regression included size, shape, echogenicity, echotexture, margins, hilum, presence of microcalcifications or necrosis, vascularization, and resistance index (RI).
  
  
  RESULTS
  The three variables with a diagnostic accuracy exceeding 80% were an altered vascularization, heterogeneous echotexture, and abnormal hilum. Malignant nodes exhibited higher RI and larger sizes than benign nodes, and the best cutoff values to distinguish malignant from benign lymph nodes were an RI of 0.77 and a short axis ≥ 0.9 cm. Altered vascularization, a short axis ≥ 0.9 cm, and abnormal hilum were the best predictors of malignancy.
  
  
  CONCLUSIONS
  The best sonographic predictors of lymph node malignancy are, in descending order, an altered vascularization, a short axis ≥ 0.9 cm, an abnormal hilum, and a heterogeneous echotexture. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:587-594, 2016.
authors: Department of Radiology of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 3o. andar, Cerqueira Cesar, São Paulo, SP CEP: 05403-001, Brazil.
authors: Maria C
authors: MC
authors: Chammas
authors: Setor de Radiologia do Hospital de Clínicas da Universidade Federal de Uberlândia, Av. Pará 1720, Jd. Umuarama, Uberlândia, MG CEP: 38405-320, Brazil. tamacedo@hotmail.com.
authors: Túlio A A
authors: TA
authors: Macedo
authors: Department of Radiology of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 3o. andar, Cerqueira Cesar, São Paulo, SP CEP: 05403-001, Brazil.
authors: Victor W
authors: VW
authors: Lo
authors: Department of Radiology of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 3o. andar, Cerqueira Cesar, São Paulo, SP CEP: 05403-001, Brazil.
authors: Andrea C
authors: AC
authors: Gomes
authors: Department of Radiology of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 3o. andar, Cerqueira Cesar, São Paulo, SP CEP: 05403-001, Brazil.
authors: Adriana
authors: A
authors: Juliano
authors: Department of Radiology of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 3o. andar, Cerqueira Cesar, São Paulo, SP CEP: 05403-001, Brazil.
authors: Giovanni G
authors: GG
authors: Cerri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000473:pathology*; D002291:Carcinoma, Papillary; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D000072281:Lymphadenopathy / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009333:Neck; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology*; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult
keywords: color Doppler ultrasound; lymph node; neck; nodal metastasis; ultrasonography