Diagnostic accuracy of Doppler Ultrasound in Diagnosis of Malignant Cervical Lymphadenopathy

Asim Shaukat, Nosheen Ahmad, Hasan Bokhari


Objectives:To determinethe diagnostic accuracy of Doppler ultrasound in diagnosis of malignant cervical lymphadenopathy taking excision biopsy (histopathology) as gold standard.Design:Cross-sectional validationstudy.

Setting: Department of Radiology Allied Hospital, Faisalabad. Period: From August 2014 to June 2015, Patientsand method:A total of 213 patients with enlarged cervical lymph nodes were recruited in this study and underwent both Doppler ultrasound and histopathological examination. Doppler Ultrasound of cervical lymph nodes was done with GE logic 5- machine by using a linear transducer of 7MHz.  Lymph nodes were characterized into malignant lymphnodes i.e nodes which are round,show peripheral blood flow,sharp margins,RI greater than 0.7 and PI greater than 1.5 and  nonmalignant lymphnodes i.e nodes which are oval,show central blood flow,indistinct margins,RI lesser than 0.7 and PI lesser than 1.5.Results:Mean age of the patients was 33.1±8.3 years. There were 139 males and 74 females were included in this study. There were 183 malignant cases on Doppler ultrasound and 30 non-malignant while 176 were malignant on histopathology and 37 were non-malignant. Sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive values were 98.8%, 75.6%, 94.8%, 95.0% and 93.3%, respectively.

Conclusion:Doppler ultrasound is a useful imaging modality in malignant cervical lymphadenopathy. Ultrasonography is an easy, reproducible, non-invasive, no risk procedure, radiation free imaging modality to examine the cervical lymphadenopathy.

Key words

Doppler ultrasound, Cervical lymph nodes, Malignancy

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