E-ISSN 2231-3206 | ISSN 2320-4672

2015, Vol:4,Issue:4

Research Articles
  • Indi J Medic Science and P Health.2015; Volume:4(4):520-526 doi : 10.5455/ijmsph.2015.13012015108
  • ROLE OF ULTRASOUND AND COLOR DOPPLER IN EVALUATION OF CERVICAL LYMPHADENOPATHY
  • Naganarasimharaju Jukuri, Ramakrishna Narra, Murali Mohan V Kuppili, Sivakanth Nalubolu,Bhimeswararao Pasupuleti

Abstract

Background: Cervical lymphadenopathy is a commonly encountered clinical problem. Patients either present with,palpable neck masses or with malignancy of the head and neck where the preoperative detection of the involved nodes,is essential. Ultrasound and color/power Doppler are used to localize the node and evaluate their multiplicity, size, shape,(roundness index), hilum status, margin, calcification, necrosis (>3 mm), and perilymphnodal edema. Color and power,Doppler is used to know the pattern of vascularity and doppler indices [resistive index (RI) and pulsatility index (PI)].,Aims and
Objective: To determine the role of ultrasound and color/power Doppler in the differentiatiation of benign and,malignant nodes and in tapering the differential diagnosis.,
Materials and Methods: Eighty lymph nodes were evaluated with ultrasound and color Doppler and correlated later with,histopathology reports over a period of 18 months (May 2013 to November 2014) referred to Department of Radiology,at Katuri Medical College and Hospital. Roundness index (<2), ill-defined margins, absence of hilum, peripheral/mixed,vascularity, RI > 0.8 ,and PI > 1.5 were the criteria taken to diagnose the malignant involvement of the lymph node.,
Results: Of the 80 lymph nodes examined, 22 are proved to be malignant on histopathology examination. Features,such as roundness index, absence of hilum, and vascular pattern demonstrated sensitivities of 91%, 86%, and 86% and,positive predictive values (PPVs) of 71%, 73%, and 86%, respectively. Among these features, pattern of vascularity and,Doppler indices showed high PPV.,
Conclusions: Ultrasound and color Doppler findings of roundness index, absence of hilum, vascular pattern, and,impedance values revealed good PPV, sensitivity, specificity, and accuracy reaching 90% in differentiating benign from,malignant lymph nodes.