TITLE OF THE TOPIC
SYNOPSIS
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
“ROLE OF HIGH RESOLUTION ULTRASOUND IN THE
EVALUATION OF NECK MASSES.”
Name of the candidate : Dr. Susan Olivia D’Souza
Guide : Dr. Vinod Hegde
Co-Guide : Dr. G. K. Swethadri
Course and Subject : M.D (Radio Diagnosis)
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Department of Radio Diagnosis,
Father Muller Medical College,
Kankanady, Mangalore – 575002.
August – 2007
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
|1. |Name of the Candidate and Address |DR. SUSAN OLIVIA D’SOUZA |
| |[in block letters] |POST GRADUATE RESIDENT |
| | |FR. MULLER MEDICAL COLLEGE KANKANADY, MANGALORE –575002. |
|2. |Name of the Institution |FR. MULLER MEDICAL COLLEGE |
| | |KANKANADY |
| | |MANGALORE – 575002. |
|3. |Course of study and subject | M.D. RADIODIAGNOSIS |
|4. |Date of admission to Course |1ST MAY 2007 |
|5. |TITLE OF THE TOPIC: |
| |“ROLE OF HIGH RESOLUTION ULTRASONOGRAPHY IN THE EVALUATION OF NECK MASSES.” |
| 6. |BRIEF RESUME OF THE INTENDED WORK: |
| | |
| |NEED FOR THE STUDY: |
| | |
| |The inadequacy of physical examination alone in the evaluation of neck |
| |masses has been well established, and various imaging modalities have been |
| |shown to have superior diagnostic accuracy. |
| |High frequency B-mode sonography has become the most important and widely employed imaging modality for the study of the |
| |neck, in particular for thyroid, parathyroids, salivary glands and lymph nodes. It is easy to perform and does not |
| |involve ionising radiation. |
| |Sonography allows not only the detection but also the characterization of the |
| |diseases of these organs, distinguishing benign from malignant lesions with high sensitivity and specificity. |
| |This study is undertaken to determine the accuracy of high resolution ultrasound as a cost effective tool in the |
| |evaluation and characterization of neck masses, and its role in establishing diagnosis and thereby treatment. |
| | |
| |6.2 REVIEW OF LITERATURE: |
| | |
| |A study conducted by Chan, Lewis & Brooke1, has found ultrasonography as a useful imaging modality for assessing cervical|
| |lymphadenopathy in patients with |
| |head and neck carcinomas. The combination of characteristics such as increased size, round shape, absence of an echogenic|
| |hilus, intranodal necrosis and peripheral or displaced vascularity have been proven to make malignancy more likely. |
| |Khati & co-workers2, have concluded from their study that ultrasound plays a prominent role in the management of thyroid |
| |disease and parathyroid adenomas. It can detect clinically impalpable thyroid nodules, and characterize them as cystic, |
| |solid or complex. |
| | |
| | |
| | |
| |Gritzmann & colleagues3, have found that in acute inflammatory diseases of the salivary glands, sonography can |
| |differentiate between obstructive and non-obstructive sialadenitis. It was also found that sonography enables the |
| |diagnosis of cysts or rannulae, and the accuracy of sonography in the assessment of |
| |sialolithiasis is approximately 90%. |
| |A study conducted by Screaton & co-workers4, concluded that the use of ultrasound guidance to enable the biopsy of |
| |non-palpable lesions and the targetting of a favorable site increases sensitivity. |
| |Ahuja & Micheal5, found that ultrasound has high sensitivity when compared with clinical examination and high specificity|
| |when combined with FNAC. A combination of gray scale and power Doppler features had a sensitivity of 92% and a |
| |specificity of 100% in depicting metastatic nodes. It was concluded that the advent of power Doppler sonography has |
| |increased the amount of information that can be obtained during sonographic evaluation of the neck. |
| |Asai & colleagues6 have found the ultrasonographic evaluation of cervical lymph nodes to be a useful tool in the |
| |diagnosis of cervical tubercular lymphadenitis versus malignant lymph nodes. Tuberculous lymphadenitis was diagnosed with|
| |a sensitivity and specificity of 100% in nodes having strong echoes and an echogenic thin layer (features specific to |
| |tuberculous lymphadenitis). |
| | |
| |OBJECTIVES OF THE STUDY: |
| | |
| |To identify the sonographic characteristics of neck masses. |
| |To determine the accuracy of high resolution ultrasound in the evaluation of neck masses. |
| |Confirmation of diagnosis with fine needle aspiration cytology/ histopathology. |
| 7. | MATERIAL AND METHODS: |
| | |
| |7.1 SOURCE OF DATA: |
| |Patients referred to the Department of Radiodiagnosis, Father Muller Medical |
| |College Hospital, for the sonographic evaluation of the neck, during the study |
| |period of 2 years. |
| | |
| |METHOD OF COLLECTION OF DATA: |
| |The study will be conducted using purposive sampling technique, on 100 |
| |patients referred to the Department of Radiodiagnosis for the |
| |sonographic evaluation of neck masses. |
| |Ultrasound examination of the neck will be performed using a linear array |
| |transducer of 7.5-10 MHz. |
| |The sonographic evaluation of the lesion will be done to note the size/shape, |
| |site, margins, appearance (solid/cystic), echotexture and vascularity. |
| |The diagnosis will be confirmed by fine needle aspiration cytology or |
| |histopathology. Surgical follow-up will be obtained wherever applicable. |
| | |
| |PLAN OF DATA ANALYSIS: |
| |Data will be analysed using sensitivity, specificity, predictive values and |
| |kappa statistics. |
| | |
| |INCLUSION CRITERIA: |
| |Patients referred for the ultrasound examination of neck masses, irrespective |
| |of age and sex. |
| | |
| | |
| | |
| | |
| | |
| |EXCLUSION CRITERIA: |
| |1. Patients presenting with: |
| |mandibular lesions. |
| |neck masses of vascular origin. |
| |apical chest lesions with extension into the neck. |
| |2. Cases in which fine needle aspiration cytology/ histopathology follow-up is |
| |not obtained. |
| | |
| |Does the study require any investigations or interventions to be conducted |
| |on patients or other humans or animals? If so, please describe briefly. |
| |Yes, ultrasound examination of patients with neck masses. |
| | |
| |7.4 Has ethical clearance been obtained from your institution in case of 7.3? |
| |Yes. |
| | |
| 8. |LIST OF REFERENCES: |
| | |
| |1. Chan J M, Lewis K S, Brooke R J. Ultrasound of abnormal neck lymph nodes. |
| |Ultrasound Quarterly, Vol.23(1) March 2007; 47-54 |
| | |
| |2. Khati N, Tamy A, Karen S J, Micheal C H. Ultrasound of thyroid and |
| |parathyroid glands. Ultrasound Quarterly, Vol.19(4) Dec 2003; 162-176 |
| | |
| |3. Gritzmann N, Rettenbacher T, Hollerweger A, Machiener P. Sonography |
| |of the salivary glands. European radiology J, Vol.13 No.5 May 2003; 964-975 |
| | |
| |4. Screaton N J, Burman L H, Grant J W. Head and neck |
| |lymphadenopathy: Evaluation with ultrasound guided cutting needle biopsy. |
| |Radiology 2002; 224: 75-81 |
| | |
| |5. Ahuja A, Micheal Y. An overview of neck node sonography. |
| |Investigative radiology, Vol.37(6) June 2002; 333-342 |
| | |
| |6. Asai S, Miyadui H, Suzuki K, Shimanura K, Anda Y. |
| |Ultrasonographic differentiation between tuberculous lymphadenitis and |
| |malignant lymph nodes. Journal of ultrasound in medicine, |
| |Vol.20(3) 2001; 533-538 |
| | |
| | |
|9. |Signature of the candidate | |
|10. |Remarks of the guide | |
|11. |Name and Designation of |DR. VINOD HEGDE MD. |
| |(in block letters) |PROFESSOR & H.O.D |
| |11.1 Guide |DEPARTMENT OF RADIODIAGNOSIS |
| | |FR. MULLER MEDICAL COLLEGE |
| | |KANKANADY, MANGALORE |
| |Signature | |
| |11.3 Co-Guide |DR. G.K. SWETHADRI MD. DCP |
| | |ASSOCIATE PROFESSOR |
| | |DEPARTMENT OF PATHOLOGY |
| | |FR. MULLER MEDICAL COLLEGE |
| | |KANKANADY, MANGALORE |
| |11.4 Signature | |
| |11.3 Head of the Department |DR. VINOD HEGDE MD. |
| | |PROFESSOR & H.O.D |
| | |DEPARTMENT OF RADIODIAGNOSIS |
| | |FR. MULLER MEDICAL COLLEGE |
| | |KANKANADY, MANGALORE |
| |11.4 Signature | |
|12. |12.1 Remarks of the Chairman and Principal | |
| | | |
| |12.2 Signature | |
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