CERVICAL LYMPHADENOPATHY - RATIO OF LONG-AXIS TO SHORT-AXIS DIAMETER AS A PREDICTOR OF MALIGNANCY

The purpose of this study was to evaluate short- and long-axis diamete rs of enlarged cervical lymph nodes with ultrasonography and to determ ine whether the long-to-short axis (1/s) ratio is a valid diagnostic p arameter in the differentiation between benign and malignant nodal dis ease. 730 enlarged cervical lymph nodes in 285 patients were examined with ultrasound. The short- and the long-axis diameters of each enlarg ed node were measured and the 1/s ratio calculated. Definite diagnoses of the nodes were obtained by histological examination following neck dissection. 95% of enlarged cervical nodes shown on ultrasound to hav e a 1/s ratio of more than 2 were correctly diagnosed as benign. Nodes presenting with a more circular shape and a 1/s ratio of less than 2 were diagnosed correctly as metastases with 95% accuracy. The 1/s rati o of lymph nodes thus provides an excellent criterion for differentiat ion between benign and malignant enlargement in cervical lymphadenopat hy.