Differentiation of Malignant and Benign Cervical Lymph Nodes with Color and Pulsed Doppler Ultrasonography

Korean Journal of Head & Neck Oncology 2001;17(1):19-25.
Published online May 30, 2001.

Kang Dae Lee;Bong Hee Lee;Yun Woo Lee;Hwan Ho Lee;Kyong Mo Ahn;Young Soo Lee

색채 및 펄스 도플러 초음파를 이용한 경부 림프절의 양성과 악성의 감별

이강대;이봉희;이윤우;이환호;안경모;이영수

Abstract

Objectives: The clinical efficacy of the color and pulsed Doppler ultrasound with spectral waveform analysis for differentiation of malignant from benign cervical lymphadenopathy was prospectively evaluated in cervical lymphadenopathy. Materials and Methods: Color and pulsed Doppler ultrasound examination was prospectively performed in 32 cervical lymph nodes in 28 patients. These 10 nodes from 10 patients were malignant and 22 nodes from 18 patients were benign, proved by operation, biopsy, and follow-up examination. Another 12 lymph nodes from 12 normal volunteers were evaluated as control group. The peak systolic velocity (PSV), minimal diastolic velocity (MDV) , and resistive indexes (RI) of arterial flows within the 32 lymph nodes were assessed to differentiate the malignant from benign nodes with pulsed Doppler ultrasonography. The results were qualitified with one-way ANOVA and Bonferroni method of multiple comparison.
Results
The mean values of PSV of malignant, benign, and control nodes were 38.2(10.1-134)cm/sec, 23.3(9-38.5) cm/sec and 11.8(6.7-18.1) cm/sec, respectively. The mean values of MDV of them were 0.9(-7.5-10.7)cm/sec, 9.7(2.9-18.6)cm/sec and 6.5(3.7-9.3)cm/sec, respectively. However, there was no statistical significance in differentiation of malignant from benign nodes with PSV and MDV. The mean values of RI of malignant, benign, and control nodes were 0.99(0.80-1.30), 0.59(0.46-0.77) and 0.45(0.38-0.50), respectively. RI value of 0.8 is suggestive value for discrimination of malignant from benign lymphadenopathy during examination of color Doppler ultrasound of cervical lymphadenopathy.
Conclusion
Color and pulsed Doppler ultrasound examination with spectral waveform analysis may be quite helpful in the differentiation between benign and malignant alterations of cervical lymph nodes.

Key Words: Cervical lymph nodes, Doppler US, Resistive index