Evaluation of efficacy of Ultrasound in diagnosis of Neck Swellings

Abstract

<p class="abstract"><strong>Background:</strong> Neck swellings are a common cause of dilemma to clinicians. Accurate diagnosis of neck swellings is of paramount importance. This study evaluated patients with neck swellings to study their ultrasonographic features and correlated the ultrasound findings with the final diagnosis.</p><p class="abstract"><strong>Methods:</strong> 100 patients with neck swellings were evaluated clinically and divided into four groups– congenital, inflammatory, benign and malignant. Thereafter, they underwent high-resolution Ultrasound (US) and the ultrasonographic features of each type of swelling were studied. A final diagnosis was established after further evaluation using FNAC, further imaging, surgical intervention in the form of incision and drainage or excision/incisional biopsy with histopathological examination or successful non-surgical treatment. Ultrasound findings were compared with final diagnosis. </p><p class="abstract"><strong>Results:</strong> For swellings of inflammatory nature, this study showed the sensitivity, specificity, PPV and NPV of US to be 87.2%, 96.6%, 94.4%, 91.9% respectively. For benign swellings, sensitivity, specificity, PPV and NPV was 97.5%, 91.3%, 88.6% and 98.1% respectively. Sensitivity of US in diagnosing malignant lesions of the neck was 87.5% with a specificity of 98.7%, PPV 93.3% and NPV 97.5%. Sensitivity of US in detecting thyroid malignancy in the present study was 83.3% and in diagnosing malignant lymph nodes was 87.5%.</p><p><strong>Conclusions:</strong> Ultrasound is the ideal modality for initial imaging for neck swellings. Later on, as per the need and Ultrasound findings, one can go in for further haematological investigations, Fine Needle Aspiration Cytology and Radiological investigations. </p>