Role of Color Doppler Ultrasound in Predicting Malignancy in Cervical Lymph Nodes

Abstract

Introduction: Cervical lymphadenopathy is a common finding in clinical practice. There are various causes, which can be broadly divided into benign and malignant. Ultrasound with color Doppler is a safe, non-invasive and widely available tool for detection and characterization of cervical lymph nodes. It can provide an insight into vascularity and flow pattern within a lymph node, thereby serving as a surrogate marker for vascular alterations seen with malignancy. Aim: To evaluate the role of color Doppler ultrasound in predicting malignancy in cervical lymph nodes. Materials and Methods: As a part of this prospective study, we performed ultrasound with color Doppler on 60 patients (34 males and 26 females). Inclusion criteria for the study was any patient with palpable abnormality in the neck who was detected to have cervical lymphadenopathy on ultrasound and color Doppler examination and subsequently had FNAC or excisional biopsy. Results: Out of 98 lymph nodes evaluated in 60 patients, 30 lymph nodes in 22 patients demonstrated malignancy on pathology. Out of these 30 lymph nodes, 24 demonstrated peripheral or mixed vascularity. The Resistivity Index (RI) values in benign lymph nodes ranged from 0.40 to 0.82 with a mean of 0.60 + 0.10. RI values in malignant lymph nodes ranged from 0.56 to 0.88 with a mean of 0.74 + 0.08. Conclusion: Color Doppler ultrasound plays an important adjunct role to ultrasound in differentiating benign from malignant lymph nodes. It adds to the diagnostic confidence of predicting malignancy in cervical lymph nodes. However, Color Doppler ultrasound can not replace histopathology for differentiation of benign and malignant cervical lymph nodes.

Keywords

• power doppler
• pulsatility index
• resistivity index
• spectral doppler