TRIPLEX ULTRASONOGRAPHIC ASSESSMENT OF CERVICAL LYMPH NODES

Detection of lymph nodes (LNs) involvement by various pathological processes has great therapeutic and prognostic implications. The purpose of this study was to evaluate the usefulness and accuracy of triplex sonography (gray scale, color mapping and spectral Doppler) in differentiating benign from malignant cervical LNs. We used triplex sonography to evaluate 120 LNs in 50 patients. The gray scale features which were considered included LNs margin, nodal shape (length/width ratio) and echotexture. Vascular patterns and arterial resistive index (RI) of the LNs were assessed by color mapping and spectral Doppler. Finally sonographic findings were compared with pathologic results. There was significant difference between benign and malignant LNs in shape, echotexture, RI and vascular pattern. Study results showed that malignant LNs, especially metastatic nodes, are accompanied with significantly high RI, rounded shape, heterogenous echotexture and peripheral vascularity. Among these sonographic findings, nodal shape (L/W ratio) and RI were more accurate for differentiating benign from malignant LNs. LNs with ill-defined margin were all metastatic. In this study triplex sonographic findings had relatively high accuracy in differentiating benign from malignant cervical LNs, however, because of some overlapping in triplex sonographic appearances of benign and malignant nodes, this modality may not have definite diagnostic value.