DIAGNOSIS OF LYMPH-NODE METASTASIS IN THE NECK BY MEASURING THE NODAL BLOOD PERFUSION WITH COLOR-CODED DUPLEX SONOGRAPHY

The objective of this study was to find additional sonomorphological criteria for determining the status of enlarged lymph nodes. By using colour-coded duplex sonography the perfusion of 63 lymph nodes in the neck was analysed. The status was confirmed either histologically or clinically (29 metastases from squamous cell carcinomas and 34 acute or chronic inflammatory nodal diseases). A quantitative evaluation of the pulsatility measured in 51 lymph nodes by computing the Pourcelot-Ratio and the Mean Pulsatility Index yielded significant differences between the two groups. By definition of a limiting value of the Pourcelot-Ratio (0,75) for the prediction of benignity, the specificity and the accuracy in screening for metastases were improved as compared to clinical examination and B-mode sonography. Additional criteria of dignity were found by qualitative evaluation of nodal perfusion patterns (presence and distribution of perfusion, partial loss of perfusion). The use of colour-coded duplex sonography in nodal disease of the neck provides an improvement of early and noninvasive diagnosis of regional metastatic involvement.