Evaluation of cervical lymph node vascularity: A comparison of colour Doppler, power Doppler and 3-D power Doppler sonography

This study was undertaken to compare the performance of colour Doppler (CDS), power Doppler (PDS) and 3-D power Doppler sonography (3-D PDS) in the assessment of vascular pattern and vessel displacement of cervical lymph nodes. Colour Doppler (2-D CDS), power Doppler (2-D PDS) and 3-D power Doppler sonograms (3D PDS) of 145 cervical nodes were reviewed (metastases n = 60, lymphoma n = 30, tuberculosis n = 23, reactive n = 25, Kimura disease n = 7). Sonograms of the three imaging modes were reviewed separately with an interval of 2 weeks. Lymph nodes were assessed for the vascular pattern (hilar, peripheral or mixed) and the presence or absence of displacement of hilar vascularity. For the assessment of displacement of hilar vascularity, only lymph nodes that showed hilar or mixed vascularity in the three imaging modes were included in the analysis. Results showed that there was a high level of agreement between CDS and PDS in assessment of vascular patterns (κ = 0.914), whereas the level of agreement between CDS and 3-D PDS (κ = 0.484) and between PDS and 3-D PDS (κ = 0.452) was low. There was a high level of agreement in the assessment of displacement of hilar vascularity among the three imaging modes (CDS and PDS, κ = 0.942; CDS and 3-D PDS, κ = 0.808; PDS and 3-D PDS, κ = 0.865). In the assessment of vascular patterns of cervical lymphadenopathy, CDS and PDS have a similar performance. However, accurate assessment of the vascular pattern of cervical nodes may be difficult using 3-D PDS. In the assessment of displacement of hilar vascularity, the performances of CDS, PDS and 3-D PDS are similar.