Recurrent cervical lymphadenopathy: differential diagnosis with color-duplex sonography

Eur Arch Otorhinolaryngol. 1994;251(7):404-9. doi: 10.1007/BF00181966.


In this prospective study 45 patients with cervical lymphadenopathy treated by operation, radiation and/or chemotherapy were examined by color-duplex sonography. The aim was to investigate the lymph node perfusion and to find out whether differentiation between benign and malignant nodal disease after therapy was possible by resistance and pulsatility indices. In 200 of 245 lymph nodes (82%) color-duplex sonography was able to detect perfusion. Using a pulsatility index (PI) threshold of 1.6 and resistance index (RI) threshold of 0.8, differentiation between reactive nodal enlargement and metastases was possible with an accuracy of 96%. Differentiation between lymphomas and metastases by RI and PI was not possible. Qualitative assessment of perfusional patterns was useful in detecting malignancy because reactively enlarged nodes showed greater hilar perfusion whereas metastases showed an increased peripheral perfusion. Lymphomas had both increased central and peripheral perfusions.

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Blood Flow Velocity / physiology
  • Carcinoma, Squamous Cell / blood supply
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / therapy
  • Connective Tissue / diagnostic imaging
  • Diagnosis, Differential
  • Follow-Up Studies
  • Histiocytosis, Langerhans-Cell / diagnostic imaging
  • Humans
  • Lymph Nodes / blood supply
  • Lymph Nodes / diagnostic imaging*
  • Lymphatic Diseases / diagnostic imaging
  • Lymphatic Diseases / pathology
  • Lymphatic Diseases / physiopathology
  • Lymphatic Diseases / therapy
  • Lymphatic Metastasis / diagnostic imaging*
  • Lymphatic Metastasis / pathology
  • Lymphatic Metastasis / physiopathology
  • Lymphoma / diagnostic imaging
  • Myeloproliferative Disorders / diagnostic imaging
  • Neck
  • Prospective Studies
  • Pulsatile Flow / physiology
  • Recurrence
  • Regional Blood Flow / physiology
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Color*
  • Vascular Resistance / physiology