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[Cervical lymph node metastasis: CT, ultrasound versus physical palpation]
1Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing.
Objective:
To evaluate the accuracy of CT, ultrasonography and manual palpation in the diagnosis of cervical lymph node metastasis and to identify the value of CT and ultrasound in the diagnosis of occult cervical lymph node metastasis.
Methods:
Sixty patients (74 sides) were studied double-blindedly by CT and ultrasonography prior to cervical lymphadenectomy, and the results were correlated with histo-pathologic findings.
Results:
According to histologic examination of the dissected specimens, in 56 of 74 sides there were cervical lymph node metastases, 46 of the 56 sides with metastatic nodes were diagnosed by manual palpation(sensitivity, 82.1%; specificity, 83.3%; accuracy, 82.4%). However, lymphnode metastases in 53 sides were revealed by CT(sensitivity, 94.6%; specificity, 94.4%; accuracy, 94.6%), i.e., CT discovered 70% of the occult metastatic nodes in this series. Lymph node metastases were diagnosed accurately in 51 sides by ultrasonography (sensitivity, 91.1%; specificity, 94.4%; accuracy, 91.9%), and 50% of the occult metastatic nodes were found by ultrasound.
Conclusion:
CT, ultrasound examinations are superior to physical palpation in ascertaining cervical lymph node metastasis, as 50%-70% of the occult cervical metastatic nodes can be diagnosed.