Color-coded duplex sonography in the head and neck: A comparison of benign and malignant cervical lymph nodes

Color-coded duplex sonography is being increasingly used in the head and neck as another method for diagnosis of such disorders as stenosis of arteries or veins or hemangiomas. A possible additional advantage of testing is the ability to differentiate benign from malignant tumors. Since the underlying cause of a suspicious lesion is most important for treatment strategies, we investigated histologically-proven benign and malignant cervical lymph nodes for determining the value of color-coded duplex sonography. In the present study, 135 patients (45 women and 90 men; ages 30-63 years) with palpable cervical lymph nodes were examined with both ultrasound and color-coded duplex sonography. Afterwards, lymph nodes were removed by open biopsies or neck dissections. The histological results were then compared to perfusion velocities and pulsation indices from the color-coded duplex sonography. However, no significant differences were found between the benign and malignant nodes. When comparing perfusion and color, each group was seen to be non-homogeneous and no typical distribution of vascularization was demonstrable. Findings showed that color-coded duplex sonography is currently not an accurate indicator of lymph node pathology.