Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy

Abstract

Background: To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign
and malignant cervical lymph nodes by detecting differences in blood flow patterns.
Materials and Methods: In this cross‑sectional prospective study, 25 untreated patients with
clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical
lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were
the key CDUS features used to differentiate between reactive and metastatic lymph nodes.
Histopathological confirmations were obtained and compared with the results of CDUS.
Results: Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty‑seven
additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters
for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum
revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar
flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for
malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler
features are used to differentiate benign and malignant nodes.
Conclusion: Within the limitations of this study, CDUS evaluation was found to be highly significant
with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect
to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.
Key Words: Doppler color ultrasonography, histopathology, lymph node, lymphadenitis