The role of gray scale and color Doppler ultrasound imaging in cervical lymphadenopathy evaluation and differentiation

Nehal Diwanji; Mahavir Swami; Mona Sastri; Nipa Patidar

Article Details

The role of gray scale and color Doppler ultrasound imaging in cervical lymphadenopathy evaluation and differentiation

Authors:

Nehal Diwanji | Mahavir Swami | Mona Sastri | Nipa Patidar

Publisher:

Eldaghayes Publisher, Tripoli, Libya

Main Topics:

Gray Scale Sonography | Power Doppler Sonography | Cervical Lymphadenopthy

Journal:

International Journal of Medical Science and Public Health Vol.6 Issue 5, pp.919-919

Document Type:

Article

Publication Date:

12/2016

Document Language:

English

Document ID (Org No.):

2001522417

pISSN:

2320-4664

Keywords:

Abstract:

 Background: Cervical lymph nodes are also common sites of involvement of lymphoma; tuberculous (TB) lymphadenitis; and other benign and malignant lymphadenitis. It is essential to evaluate the cervical lymph nodes in various head and neck diseases. The role of gray scale sonography of neck lymph nodes is well established and it is widely utilizes for the evaluation of the number, size, site, shape, borders, matting, adjacent soft-tissue edema, and internal architectures of cervical lymph nodes. The advance research in power Doppler sonography (PDS) has further increased the utilization of ultrasonographic (USG) evaluation of cervical lymph nodes for diagnostic purpose. 
 
 Objectives: The aim of this study is to evaluate the importance of gray scale, Doppler and spectral waveform study in differentiation of benign and malignant neck lymphadenopathy and to find out sensitivity and specificity of gray scale, Doppler and spectral waveform study in differentiation of benign and malignant neck lymphadenopathy. 
 
 Materials and Methods: Patients were chosen from the outpatient department and from admissions in wards of otorhynolaryngology and surgery department. Patients with neck swelling are screened with USG. If USG shows the enlarged lymphnode, then detailed study was performed by gray scale, color, power Doppler, and by spectral waveform analysis. For differentiation from metastatic lymph nodes criteria given by Ahuja was utilized. 
 
 Results: A total of 100 enlarged neck lymph nodes studied in 75 patients with neck lymphadenopathy. Metastatic lymph node enlargement was 38.67%, lymphoma 6.67%, TB 28%, and reactive 26.66%. Moreover male: female ratio was 2.6:1. The percentage of L/S ratio 2. 76% metastatic, 56% lymphoma, 72% of TB lymphadenopathy had the loss of echogenic hilum, whereas 76% reactive nodes preserved echogenic hilum. The mean resistive index (RI) and pulsatality index (PI) value of metastatic nodes 0.81, 1.87, lymphomatous nodes 0.8, 1.36; TB nodes 0.67, 1.17 and for reactive nodes 0.61, 1.05, respectively. Sensitivity of RI for malignant lymph nodes is 39%, specificity is 84%. While the sensitivity of PI for malignant lymph nodes is 44%, specificity is 87%. 
 
 Conclusion: Gray scale and PDS helps in differentiation of metastatic, lymphomatous, and TB nodes from reactive nodes. The sonographic criteria most predictive of metastatic cervical lymph nodes were absent hilar echoes, increases in short axis length, necrosis, peripheral, or mixed vascularity. However, there is similarity in appearance to some extent between TB nodes, benign reactive neck nodes, and metastatic nodes. And thus, histological analysis is still utilized for a definitive diagnosis.

Article Details

The role of gray scale and color Doppler ultrasound imaging in cervical lymphadenopathy evaluation and differentiation

Authors: Nehal Diwanji | Mahavir Swami | Mona Sastri | Nipa Patidar

Publisher: Eldaghayes Publisher, Tripoli, Libya

Main Topics: Gray Scale Sonography | Power Doppler Sonography | Cervical Lymphadenopthy

Journal: International Journal of Medical Science and Public Health Vol.6 Issue 5, pp.919-919

Document Type: Article

Publication Date: 12/2016

Document Language: English

Document ID (Org No.): 2001522417

pISSN: 2320-4664

Gray Scale Sonography

Power Doppler Sonography

Cervical Lymphadenopthy

Issues

Authors:

Nehal Diwanji | Mahavir Swami | Mona Sastri | Nipa Patidar

Publisher:

Eldaghayes Publisher, Tripoli, Libya

Main Topics:

Gray Scale Sonography | Power Doppler Sonography | Cervical Lymphadenopthy

Journal:

International Journal of Medical Science and Public Health Vol.6 Issue 5, pp.919-919

Document Type:

Article

Publication Date:

12/2016

Document Language:

English

Document ID (Org No.):

2001522417

pISSN:

2320-4664