The value of Doppler sonography in differential diagnosis of cervical lymphadenopathy

Muhsin Ali, Eaman

	The value of Doppler sonography in differential diagnosis of cervical lymphadenopathy
kufa Journal for Nursing sciences
Article 1, Volume 1, Issue 1, 2011, Pages 99-112
Author
eaman muhsin Ali
Abstract
Abstract In this prospective study we evaluate Doppler spectral parameters in lymphomatous, reactive , metastatic and acute inflammatory lymph nodes & evaluated the pulsed Doppler sonography as a technique to distinguish between different causes of cervical lymphadenopathy. Spectral Doppler analysis with measurement of resistance index (RI) , pulsatility index (PI) , peak systolic velocity (PSV) &End diastolic velocity (EDV) was performed in 100 patients with cervical lymphadenopathy . The results of Doppler analysis were compared with findings of cytology & histology or with clinical presentation & follow up . T-test was used to assess statistical significance of differences in Doppler parameters between groups of patients . Significant differences in RI & PI were shown between all groups of patients except between lymphomatous & reactive lymph nodes. Specificity of 100% for metastatic nodal involvement was shown for cutoff values RI>0.80 & PI > 1.80 . A positive predictive value (PPV) of 100% for acute lymphadenitis was shown for cutoff values RI < 0.50 & PI < 0.60. An EDV > 10 cm/s has 100% negative predictive value for nodal metastasis , & EDV < 2 cm/s has 100% specificity & PPV for metastases . Although there exist differences in RI , PI , PSV & EDV between different nodal diseases , unfortunately, only extreme cutoff values may occasionally be helpful in differential diagnosis. Doppler spectral analysis is a valuable noninvasive adjunct which can help in differentiation between metastatic , lymphomatous , acute inflammatory & reactive lymphadenopathy , but cannot eliminate the need for biopsy in the majority of cases.

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