[Cervical lymph node metastases: a histologically controlled comparison of palpation, sonography and computed...

Sonography and CT were used pre-operatively for lymph node staging in patients with head and neck malignancies. The accuracy of the imaging methods surpassed that of palpation (palpation 85%, CT 85%, sonography 90%). Sensitivity was significantly increased from 74% (palpation) to 84% (CT) and 90% (sonography), ie. there was a reduction in false negative findings. Size of lymph nodes was not closely correlated with metastatic involvement. Reactively enlarged lymph nodes were more easily defined by CT and sonography than by palpation. This reduced the specificity of sonography (90%) and of CT (86%) compared to palpation (94%).