A vivid way of differentiating benign and malig-nant cervical lymph node through b-mode ultrasonography and sonoelastography

Abstract

Cervical lymphadenopathy is not a diagnosis but it is a sign or symp-tom. The etiology could be inflammatory or degenerative or neoplastic. Cervical lymph node evaluation plays a vital role in patients with head and neck cancers because the results determine the prognosis and choice of therapy. Ultrasonography can be used to assess the mor-phology, site, number, size and vascularity of cervical lymph node. However, the ultrasound criteria for metastatic lymph nodes are con-troversial. Sonoelastography is a novel imaging modality introduced as a non-invasive technique for evaluating cervical lymph nodes and to map the elastic properties of examined soft tissue. Neck lymph nodes are easily accessible and can be efficiently compressed against under-lying anatomical structures, with use of an ultrasound transducer for elastographic tissue characterization. The detail about the rigidity of a lymph node gives us the direction for percutaneous biopsy and nodal dissection under ultrasound guidance. Use of this information can also improve patient follow-up by enabling detection of cancer recurrence at an early stage. The study aims to differentiate benign and malignant cervical lymph nodes by observing the morphology, vascular Pattern and strain ratio cut-off value. In this trial 40 patients with cervical lym-phadenopathy were studied and the study concluded that Ultrasound elastography is a specific test unlike B-mode ultrasonography in dif-ferentiating benign and malignant cervical lymphadenopathy. The strain ratio cut-off value for benign vs malignant lymphadenopathy is 1.78. Thus Sonoelastography along with B-mode ultrasound increases the rate of detection of malignancy.