Evaluation of the Sonographic Features of Metastatic Cervical Lymph Nodes in Patients With Head and Neck Malignancy

Objectives: The aim of the study was to evaluate the sonographic findings of metastatic cervical lymph nodes and of differentiating them from benign ones in patients with head and neck malignancy. Methods: In this study, the cervical lymph nodes of 14 patients (12 female and 2 male patients; mean age, 52.8 years (with head and neck region malignancy were evaluated ultrasonographically. The gray-scale sonographic parameters, which included short-and long-axis lengths, shape index, presence or absence of hilar echoes and cystic necrosis, parenchymal echogenicity and echo texture, margin, and the color Doppler parameter including vascular pattern were evaluated. Finally, sonographic findings were compared with pathologic results. The following statistical analyses were included: chi(2) test, Fisher exact test, and independent-samples t-test. Results: Overall, 88 cervical lymph nodes were evaluated ultrasonographically. According to the histopathologic results, 77% of them were benign, and 23% were malignant. The study's results showed that the metastatic lymph nodes are accompanied with significantly larger size, rounded shape, absence of hilus, and presence of cystic necrosis and mixed and peripheral vascular pattern. The parameters related to minimal and maximal axis diameter had the highest sensitivity (85%), whereas 2 parameters of vascularity pattern and cystic necrosis had 100% specificity in detecting metastatic cervical lymph nodes. Conclusions: The results of our study revealed that there was a considerable difference in the diagnostic value of the sonographic parameters, in differentiating metastatic lymph nodes from benign ones, between 4 specific neck regions.