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Abstract
Routine sonographic examination of neck nodes now includes both grey-scale and Doppler
sonography. Although the addition of Doppler sonography to the well-established practice
of grey-scale sonography increases the amount of information obtained by sonography,
it also increases the examination time, particularly if spectral Doppler and estimation
of vascular resistance is performed. This study was, therefore, undertaken to evaluate
whether Doppler sonography is routinely indicated in every case or its use should
be limited to those cases where grey-scale sonography is equivocal. We evaluated the
grey-scale and power Doppler sonograms of 101 fine-needle aspiration cytology (FNAC)-proven
metastatic nodes and 72 FNAC-proven nonmetastatic nodes. All lymph nodes were evaluated
with grey-scale and power Doppler sonography. The shape, echogenicity, internal architecture,
vascular distribution and vascular resistance of the lymph nodes were evaluated. Grey-scale
sonographic features evaluated in this study had a high sensitivity (95%) and specificity
(83%) in classifying metastatic and nonmetastatic nodes. Metastatic and nonmetastatic
lymph nodes that could not be classified by grey-scale sonography demonstrated Doppler
features that helped in their correct identification. Power Doppler sonography is
not necessary for every case in routine clinical practice, but is essential and useful
in patients where grey-scale sonography is equivocal. In this study, power Doppler
sonography aided in the diagnosis in 5% and 17% of patients with metastatic and nonmetastatic
nodes, respectively.