| Objective:To evaluate the value of three-dimensional ultrasound in diagnosis of the medulla department and blood flow in benign and malignant cervical lymph node. Methods:98 cervical enlarged lymph nodes were divided into benign (reactive hyperplasia) and malignant groups (lymphoma, metastatic lymph nodes) according to two-dimensional ultrasound results in 98 patients. These lymph nodes were detected by three-dimensional ultrasound, The medulla of Lymph nodes volume and total volume were measured by VOCAL (Virtual Organ Computer-Aided Analysis) software with three-dimensional ultrasound, the Vm/Vt was calculated, while the medulla morphology and vascular pattern were observed. ROC curve was used to evaluate the diagnosis value of Vm/Vt, three-dimensional flow model and three-dimensional medulla form in difficult lymph node of benign and malignant lesions. Agreement was measured with Kappa statistics between ultrasonography signs and pathology. Results:There were statistically significant differences of Vm/Vt, three-dimensional flow model and three-dimensional medulla form between benign and malignant lymph nodes (P<0.001). The area of them under the ROC curve (area under the curve, AUC) were 0.790,0.960,0.874, the diagnostic accuracy of the three were high (0.7 to 0.9). The best cutoff of the evaluation of benign and malignant lymph nodes was 0.133, the sensitivity and the specificity were 80.4% and 67.3%. The Kappa values of the three were 0.473,0.918,0.737, Vm/Vt and three-dimensional medulla form have a high degree of agreement with pathology results (0.4≤K<0.7). Three-dimensional flow model has a higher degree of consistent with of pathology (0.75≤K). Conclusions:Vm/Vt could be a quota reference index for differential diagnosis of the cervical lymphadenopathy by ultrasound, and has good value in differential diagnosis. Three-dimensional flow model and three-dimensional medulla form have great diagnostic value in the cervical lymphadenopathy.
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