Role of ultrasound and color Doppler in evaluation of cervical lymphadenopathy
Journal Title: International Journal of Medical Science and Public Health - Year 2015, Vol 4, Issue 4
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.
Authors and Affiliations
Naganarasimharaju Jukuri, Ramakrishna Narra, Murali Mohan V Kuppili, Sivakanth Nalubolu, Bhimeswararao Pasupuleti
Keywords
Related Articles
- EP ID EP95446
- DOI http://dx.doi.org/10.5455/ijmsph.2015.13012015108
- Views 115
- Downloads 0
Knowledge and practices regarding breastfeeding: A community-based cross-sectional study in a rural area of Northwest India
Background: Breastfeeding (BF) practices remain the cornerstone to reduce infant and child morbidity and mortality. Objective: This study was conducted to assess the knowledge and practices regarding BF among mothers of...
Comparison between hyperbaric Bupivacaine and hyperbaric Bupivacaine plus Fentanyl intrathecally in major gynaecological surgeries
Background: Subarachnoid block is commonest anaesthetic technique used for most gynaecological surgeries. Local anaesthetic agents have traditionally been used for this, but with the discovery of opioid receptors...
A prospective study of radiation-induced hypothyroidism in head and neck cancer patients
Background: Head and neck cancers are one of the most common cancers worldwide. Radiotherapy is the only curative treatment, besides surgery. The most common clinical late effect of thyroid gland irradiation in patients...
Epidemiological and virological characterization of influenza A virus subtype H1N1 at tertiary-care hospital, Ahmedabad
Background: In April 2009, a new strain of influenza virus, A H1N1, started to spread in various parts of the world, and the first case was reported on May 16, 2009. [1] The associated morbidity and mortality have...
Awareness and attitude about carcinoma cervix and human papillomavirus vaccine: A cross-sectional study among undergraduate female medical students
Background: Cancer cervix is the leading type of cancer in India. One woman die of cervical cancer in every 8 min in India. The primary cause of developing cervical cancer is chronic infection with high-risk human papill...