الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
The diagnosis of malignant lymphadenopathy is crucial for therapeutic planning in patients with suspected malignant neoplasm and for pre-treatment staging in patients with primary malignant tumors of head and neck. (1)
The aim of this work is to depict the role of high resolution ultrasonography and color as well as power Doppler ultrasonography in differentiating benign from malignant lymphadenopathy.
Forty patients with cervical lymphadenopathy were included in our study (13 non-specific inflammatory nodes, 3tuberculous nodes, 16 lymphomatous nodes and 8 metastatic nodes). The lymph nodes were subjected to ultrasonography and Doppler studies correlated with clinical and pathological diagnosis obtained by lymph nodes biopsy.
Regarding the vascular pattern of each lymph node, our study showed that the main vascular pattern of inflammatory lymph nodes was hilar pattern(88%) and of lymphomatous nodes was mixed (hilar and peripheral) pattern (57%) and of metastatic nodes was peripheral pattern (75%).
Regarding the resistivity index with a cutoff point 0.7, this study showed that all lymph nodes with RI value < 0, 7 were malignant (either primary or metastatic) but not all the lymph nodes with RI value >0.7 were benign, 57% of lymph nodes with RI >0.7 (16 of 28) were benign and 43% (12 of 28) were of primary nodal affection. This study also showed that The sensitivity and specificity of RI for detecting malignant lymph nodes were 50 % and 100 % respectively from this study we concluded that:
The high resolution ultrasonography played an important role in differentiation between benign and malignant lymphadenopathy based on the shape (longitudinal/ transverse ratio), hilum, cortical thickness, cortical echogenicity and intra-nodal necrosis.
Assessment of intra-nodal angio-architecture was used to differentiate benign from malignant cervical lymphadenopathy. It was observed that hilar pattern predominated in benign lymph nodes, while sub-capsular pattern predominated in malignant lymph nodes.
Regarding the use of resistivity index of more than 0,7 showed sensitivity of detecting malignant lymphadenopathy of 50%. There for, the value of spectral Doppler ultrasonography evaluation of intra-nodal vascular resistance is limited in routine clinical practice.