Ultra sonography of metastatic cervical lymph nodes in patients with head and neck cancer : at Kenyatta National Hospital

Abstract

Main objective: To evaluate the role of High - Resolution U/S in detecting metastatic neck nodes metastases in patients with head and neck cancer. Study design: Descriptive Cross - Sectional Study Setting: Kenyatta National Hospital - Nairobi Methods and materials: Patients with head and neck cancer presenting at Ear, Nose and Throat, Head and Neck Surgery Department - Kenyatta National Hospital, were evaluate for cervical lymphadenopathy by physical, examination, contrast enhanced CT and U/S. The neck findings were correlated with cytopathological findings of lymph node biopsies. Results: A total of 152 consecutive patients were included in the study 111(73%) patients were males and 41 (27%) were females. The mean age ratio was 54.9 years. General examination and detailed otolaryngological evaluation was done. Neck findings were documented patients were also evaluated using contrast- enhanced CT & U/S 69 patients underwent FNA biopsy of neck nodes. 71 (46.7%) of the patients had palpable clinical lymph nodes, 59 out of 69 patients done FNA were confirmed to have metastatic nodes. CT detected nodes in 54(35.5%) patients; 48 out of the 54 patients were noted to have metastasis after FNA cytology. U/S detected lymph nodes in necks of all patients had nodes which exhibited features of metastasis. 55 (36.2%) patients were correctly diagnosed with nodal metastasis on U/S. Overall agreement between cytopathological findings and PIE, CT, and-U/S IN detecting neck nodal metastasis was 85.5%, 8l.4%, and 93.6% respectively. CONCLUSION U/S proved more accurate in staging cervical lymph node metastases compared with PIE and CT