Servikal lenfadenopatilerin ayırıcı tanısında B-mod, renkli ve power Doppler ultrasonografinin etkinliği
Ziver Ayata, Melda Apaydın, Makbule Varer, Ayşegül Sarsılmaz, Çağlar Çall,, Türkan Rezanko
FREE FULL TEXT Anahtar Kelimeler: B-mod ultrasonografi; servikal lenfadenopati; renkli Dopplerultrasonografi; power Doppler ultrasonografi.
Differential diagnosis in cervical lymphadenopathies: efficacy of B-mode, color and power Doppler ultrasonography
Ziver Ayata, Melda Apaydın, Makbule Varer, Ayşegül Sarsılmaz, Çağlar Çall,, Türkan Rezanko
Objectives: Our purpose was to investigate cervical lymphadenopathies
by using color Doppler spectral analysis and power Doppler
ultrasonography methods as well as B-mode ultrasound and to classify
them as malignant or benign lesions and to compare the results
with the histopathological findings.
Patients and Methods: Sixty nine lymph nodes of 69 patients were
evaluated with color and power Doppler ultrasonography as well as
B-mode ultrasonography. The shape and dimensions of the lymph
nodes were assessed with B-mode ultrasonography; their vascularization
pattern with power Doppler sonography and with color Doppler
spectral analysis. Vascular pattern was evaluated according to the
vascularization of the lymph node. Vascular resistive index and pulsatility
index were assessed by at least three flow samplings. We measured
resistive index, pulsatility index, peak systolic velocity, and end diastolic
velocity. Results of Doppler analysis were compared with clinical findings
and histopathologic results. Nodes were grouped as metastasis,
lymphoma, tuberculosis, and reactive benign lymphadenopathies with
respect to ultrasonographic results.
Results: Forty four of 69 lymph nodes were found to be malignant
histopathologically. In color Doppler analysis, most malign metastatic
lymphadenopathies showed peripheral (76.4%), and the rest of them
(23.6%) showed peripheral and hilar (mix) vascularization. Most
benign lymphadenopathies (88%) and lymphomatous lymphadenopathies
(85%) had hilar vascularization. In tuberculous lymphadenopathies,
50% of them showed avascular pattern and the rest of them
had variable type of vascularization. A resistive index greater than
≥
0.7 indicated a malignant metastatic lymphadenopathy and a resistive
index <0.5 was consistent with benign lesions. In lymphomatous
and tuberculous lymphadenopathies resistive index values were
between 0.6-0.7. The sensitivity of the resistive index for distinguishing
inflammatory from neoplastic lymphadenopathies was 84.6%, the
specificity 100% and the diagnostic accuracy 95.7% (p<0.001).
Conclusion: In addition to B-mode ultrasonography findings, vascularity
pattern assessment and spectral analytilic measurements with color
and power Doppler ultrasonography has an important contribution for
the differential diagnosis of cervical lympadenopathies. Key words: B-mode ultrasonography; cervical lymphadenopathy; color Dopplerultrasonography; power Doppler ultrasonography.
Ziver Ayata, Melda Apaydın, Makbule Varer, Ayşegül Sarsılmaz, Çağlar Çall,, Türkan Rezanko. Differential diagnosis in cervical lymphadenopathies: efficacy of B-mode, color and power Doppler ultrasonography. Kulak Burun Bogaz Ihtis Derg. 2009; 19(4): 173-178
Corresponding Author: Ziver Ayata |
