Predicting malignant neck lymphadenopathy using color duplex sonography based on multivariate analysis
Maria C Chammas1, Túlio A A Macedo2, Victor W Lo1
1Department of Radiology of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 3o. andar, Cerqueira Cesar, São Paulo, SP CEP: 05403-001, Brazil.
Journal of Clinical Ultrasound : JCU
|August 6, 2016
Summary
Altered vascularization, abnormal hilum, and heterogeneous echotexture are key sonographic predictors of cervical lymph node malignancy. These findings aid in distinguishing malignant from benign lymph nodes using ultrasound.
Area of Science:
- Medical Imaging
- Diagnostic Ultrasound
- Oncology
Background:
- Cervical lymph node evaluation is crucial for diagnosing malignancy.
- Sonography plays a vital role in assessing lymph node characteristics.
Purpose of the Study:
- To identify the most effective sonographic predictors of cervical lymph node malignancy.
- To utilize multivariate analysis for selecting optimal diagnostic parameters.
Main Methods:
- Sonographic evaluation of 97 cervical lymph nodes prior to fine-needle aspiration biopsy.
- Analysis of gray-scale and power Doppler parameters including size, vascularization, echotexture, and hilum using logistic regression.
Main Results:
- Altered vascularization, heterogeneous echotexture, and abnormal hilum demonstrated diagnostic accuracy over 80%.
- Malignant nodes showed higher resistance index (RI) and larger size.
- Optimal cutoff values identified: RI of 0.77 and short axis ≥ 0.9 cm.
Conclusions:
- The primary sonographic predictors of lymph node malignancy are altered vascularization, short axis ≥ 0.9 cm, abnormal hilum, and heterogeneous echotexture.
- These findings enhance the diagnostic capability of ultrasound in cervical lymph node assessment.
