Applications of ultrasonography in the diagnosis of soft tissue swellings of the carvicofacial region

Abstract

Purpose: To determine the accuracy, sensitivity, specificity and prediction values of ultrasound as a means of diagnosis of cervico-facial soft tissue swellings. Materials and methods: We carried out ultrasonographic evaluation of 76 consecutive cases of cervico-facial soft tissue swellings that presented at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria from August 2002 to November 2003. The patients' demographics and relevant clinical information were obtained. Ultrasonographic evaluation was done using the B-mode transcutaneous ultrasonic imaging device with a transducer frequency of 5MHz. All the lesions were subjected to histopathological examination. Results: There were 43(56.6 %) males and 33(43.4%) females whose ages ranged from 2 weeks to 70 years (mean ± SD; 22 ± 19.7 years). Histologically, tumours constituted the highest percentage of swellings (35.5%), followed by cysts (26.3%). Males were more predominant in all classes of swellings except benign tumours. The accuracy of ultrasound in the diagnosis of pleomorphic adenoma was 80% and 100% for both adenocarcinoma and hemangioma. It was also 100% for majority of the cysts and HIV associated salivary gland swellings. The sensitivity of ultrasound in the diagnosis of pleomorphic adenoma was 80% and 100% for adenocarcinoma, hemangioma, all the cysts and HIV associated swellings. Ultrasound was also 100% specific in the diagnosis of monomorphic adenoma and hemangioma. Conclusion: Ultrasound is a useful diagnostic tool for cervicofacial soft tissue swellings. The accuracy of diagnosis is enhanced by the characteristics of the probe and the experience of the sonologist.