Differential diagnosis of cervical lymphadenopathy: usefulness of color Doppler sonography.

Abstract

The purpose of this study was to evaluate the usefulness of color Doppler sonography in differentiating benign from malignant cervical lymphadenopathy.We used color Doppler sonography to evaluate 117 lymph nodes in 105 patients. The patients were pathologically and clinically confirmed to have benign reactive lymphadenitis (n = 28), tuberculosis (n = 17), lymphoma (n = 14), and metastasis (n = 46). The patterns of hilar vascularity, central nodal vascularity, and peripheral vascularity were assessed. The highest resistive index and pulsatility index in 116 lymph nodes were measured from spectral waveforms. Histologic findings of nodal vessels were analyzed in 14 nodes and compared with findings on color Doppler sonograms.Thirty-two (94%) of 34 nodes with benign reactive disease showed normal patterns of nodal vascularity; central hilar vascularity, radial symmetric central vascularity, and no peripheral vascularity. At least one of six abnormal patterns of vascularity (eccentric or absent hilar vascularit...