Qamar Sardar, Mamoon Qureshi, Kamran Ch.
Predictive Value of Ultrasonography in the Differential Diagnostics of Adult Neck Masses.
Proceeding Shaikh Zayed Postgrad Med Comp Jan ;23(1):19-27.

Background: The role of radiologists is to differentiate between conditions using imaging modalities such as, ultrasound, Computerized Tomography and Magnetic Resonance Imaging. Where appropriate the radiologist will stage lesions for management purposes and aid in guiding aspiration and biopsy, Proper evaluation of the adult neck masses is important and ultrasonography plays a very important role in neck mass differential diagnosis. Objectives: To asses the predictive value of ultrasonography in differential diagnostics of adult neck masses and to find out the frequency of the different types of neck masses among adult patients presenting in a tertiary teaching hospital. Study Design: Cross sectional study. Study Setting: Study was conducted in radiology department of a tertiary care, teaching hospitals Jinnah hospital Lahore. Sample Selection: 73 subjects with defined neck masses not undergone diagnostic biopsy were recruited for the study. Results: 73 subjects were recruited for the study. The Sonographic consistency of neck masses shows 65.8% solid masses 15.1% cystic masses and 19.2% are mixed consistency. Comparison of diagnostic accuracy of ultrasonography with FNAC (Gold standard) revealed that the infective neck masses diagnostic accuracy is 27.4% on sonography as compared to 24.7% on FNAC. Cystic neck mass diagnostic accuracy was 19.2% on both FNAC as well as sonography. The diagnostic accuracy in benign neck masses showed 26.0% on FNAC and 37.0% on sonography. The diagnostic accuracy in neoplastic neck mass was 17.8% on FNAC and 9.6% on sonography. The metastatic neck mass 12.3% FNAC and 6.8% is sonography. The screening value of ultrasonography for infective neck mass the sensitivity is 90.0%, specificity is 96.2%, for cystic mass showed a 100% sensitivity, specificity, for benign neck masses showed a sensitivity 100%, for neoplastic neck mass depicted a sensitivity 53.8%, specificity. Conclusions: The study results suggest that Modem ultrasound is highly valuable, useful, and reliable in the differential diagnosis of tumors in the preauricular area, submandibular area, and cheek. It enables precise localization, measurements, and assessment of the structure of lesions. It may be the first and last imaging method needed to formulate the final diagnosis, or it may guide fine-needle aspiration biopsy. In many cases, ultrasound may also suggest the nature of the tumor. The accuracy of ultrasound in detecting neoplastic lesion, and metastatic lesions turned out quite lower than expected.

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