Diagnostic performance of Ultrasound and Doppler in differentiating Benign and Malignant Cervical Lymph Nodes

Abstract

Introduction: Ultrasonography is a noninvasive, nonionizing imaging technique which enables to see the anatomical structures with the use of ultrasound waves and provides valuable diagnostic information. ultrasound uses a gray scale to detect the various anatomical structures of the body and study their morphological characteristics and is capable of detecting vessels as small as those found in lymph nodes.Aims: To evaluate cervical lymphnodes in patients presented with neck masses in differentiation of Benign and MalignantCervical Lymph Nodes by Ultrasound and Doppler and to correlate them with histopathological finding. Materials and methods: A prospective diagnostic study was performed on 72  patients with  neck masses treated with complaint of palpable cervical lymph node. All patients’ necks were scanned multidirectionally by gray-scale and Doppler techniques. After sonography, lymph nodes were biopsied and investigated to find out whether they were Benign (reactive, tubercular) or Malignant(metastatic or lymphomatous)Results: High-resolution Ultrasonography showed a sensitivity of 90%  and specificity of 100%  in detecting tubercular lymphadenitis, sensitivity of 95.6% and 95.9% specificity in the detection of reactive lymphadenitis, sensitivity of 89.4% and specificity of 96.2% in detecting metastatic lymphadenopathy, sensitivity of 83% and specificity of 98% in the detection of  Lymphomatous Lymph nodes. USG diagnosis made based on the features mentioned above proved to be highly significant. Conclusion:Ultrasound is safe, cost-effective, informative, easily available in clinical practice, takes few minutes of examination with experienced sonologist, most neck masses can be assessed and diagnosed with a great deal of accuracy.