Possibilities of ultrasonographic differentiation of neck and axillary lymphadenopathy

Česká verzia

Authors: I. Hrazdira; M. Krupová; H. Kyselová
Authors place of work: Oddělení ultrazvukové diagnostiky Kliniky zobrazovacích metod Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Petr Krupa, CSc.
Published in the journal: Vnitř Lék 2005; 51(12): 1371-1374
Category: Přehledný referát

Summary

Technical development of ultrasonography connected with improvement of resolving power has enlarged possibilities in detection and differentiation of lymph nodes. In the current clinical practice ultrasonic examination is most frequently requested for assessment of lymph nodes in neck and axillary regions in connection with inflammatory or tumour diseases. Although the final diagnosis must be confirmed histopathologically, there exist some echographic criteria enabling with a great probability to appoint the malignant character of lymph nodes: round shape expressed by the shape index near to 1, sharp edges, heterogeneous echostructure and mainly loss of the hilar sign. In highly enlarged lymph nodes these criteria can be completed by colour Doppler examination revealing a peripheral type of intranodal vascularity and increased value of impedance indices in supply artery (RI > 0.8, PI > 1.8).

Keywords:
lymph nodes - ultrasonography - colour Doppler - blood supply

Zdroje

1. Ahuja A. Ying M. Grey-scale sonography in assessment of cervical lymphadenopathy: review of sonographic appearances and features that may help a beginner. Br J Oral Maxillofac Surg 2000; 38: 451-459.

2. Ahuja A, Ying M. An overview of neck sonography. Incest Radiol 2002; 37: 333-342.

3. Ahuja A, Ying M. Sonography of Neck Lymph Nodes. Part II. Abnormal Lymph Nodes. Clin Radiol 2003; 58: 359-366.

4. Benzel B, Zenk J, Winter M. Farbdopplersonographische Untersuchungen von benignen und malignen Halslymphknoten. HNO 1996; 44: 666-671.

5. Brnic Z, Hebrang A. Usefulness of Doppler waveform analysis in differential diagnosis of cervical lymphadenopathy. Eur Radiol 2003; 13: 175-180.

6. Dybiec E, Brodzisz A, Pietka M. The application of ultrasound contrast, 3D imaging and tissue harmonic imaging in the differential diagnosis of lymph nodes enlargement in children. Ann Univ Mariae Curie Sklodowska (Med) 2002; 57: 131-142.

7. Giovarnorio F, Caiazzo R, Avitoo A. Evaluation of vascular patterns of cervical lymphnodes with power doppler sonography. J Clin Ultrasound 1997; 25: 71-76.

8. Görges R, Eising EG, Fotescu D et al. Diagnostic value of high-resolution B-mode and power-mode sonography in the follow-up of thyroid cancer. Eur J Ultrasound 2003; 16: 191-206.

9. Gritzmann N, Hollerweger A, Macheiner P et al. Sonography of soft tissue masses of the neck. J Clin Ultrasound 2002; 30: 356-373.

10. Grotz KA, Krummenauer F, Al-Navas B et al. Does ultrasonographic-morphologic staging of lymph nodes in head and neck cancer lend itself to automation? Ultraschall Med 2000; 21: 93-100.

11. Hrazdira I. Stručné repetitorium ultrasonografie. Praha: Audioscan 2003.

12. Hrazdira I, Kotulánová E, Maryšková V. Barevné dopplerovské metody a jejich diagnostický význam. Vnitř Lék 2003; 49: 563-566.

13. Chudáček Z jr. Ultrasonografie hlavy a krku. Čes Radiol 1998; Suppl 1: 62-75.

14. Koischwitz D, Gritzmann N. Ultrasound of the neck. Radiol Clin North Am 2000; 38: 1029-1045.

15. Solbiati L, Rizzatto G, Belotti E. High resolution sonography of cervical lymph nodes in head and neck cancer: criteria for differentiation of reactive versus malignant nodes. Radiology 1988; 169: 113-116.

16. Tschammler A, Heuser B, Ott G et al. Pathological angioarchitecture in lymph nodes: Underlying histopathologic findings. Ultrasound Med Biol 2000; 26: 1089-1097.

17. Tschammler A, Beer M, Hahn D. Differential diagnosis of lymphadenopathy: power Doppler vs color Doppler sonography. Eur Radiol 2002; 12: 1007-1016.

18. Vomáčka J, Houserková D, Michálková K et al. Role barevně kódované duplexní sonografie v diagnostice uzlinových syndromů na krku. Čes Radiol 1998; Suppl 1: 75-78.

19. Yang WT, Metreweli C, Lam PKW et al. Benign and Malignant Breast Masses and Axillary Nodes: Evaluation with Echoenhanced Color Power Doppler US. Radiology 2001; 220: 795-802.