A clinical study of diagnosing lymph node metastases from head and neck cancer using ultrasonography

Abstract

Evaluating metastases to cervical lymph nodes is important and requires accurate diagnostic methods. The present study investigated the diagnosis of metastases to cervical lymph nodes by ultrasonography. We reviewed 88 neck dissections in 62 patients who underwent neck dissection between January and December 2012. This review resulted in 61% sensitivity, 97% specificity, and 90% accuracy. Ultrasonographic evaluation involving internal echo patterns of the lymph nodes provided more accurate diagnoses than thickness alone. The sensitivity, specificity, and overall accuracy of this diagnostic method allowed easier diagnosis of lymph node metastases in oral carcinomas than in pharyngeal carcinomas. Pathological features of false-negative results were small amounts of keratin and necrosis, a metastatic focus within a lymph node aside from the hilum of the lymph node and diffuse cellular infiltration. Diagnosis of metastases to cervical lymph nodes by ultrasonography alone has limitations, so the use of other modalities like computed tomography, magnetic resonance imaging, and positron emission tomography is important, and fine-needle aspiration during ultrasonography can improve diagnosis.