COLOR-CODED DUPLEX SONOGRAPHY FOR THE DIFFERENTIAL-DIAGNOSIS OF CERVICAL LYMPH-NODE ENLARGEMENT

55 patients with cervical lymph node enlargement were studied prospectively by colour coded duplex sonography. The aim was to demonstrate the perfusion of individual lymph nodes and to determine whether the resistance and pulsatile index are able to show the cause of the enlargement. The lymph nodes were subsequently examined histologically. Useful perfusion measurements were obtained in 177 lymph nodes out of 216. Perfusion index <1.6 and resistance index <0.8 distinguishes between reactive lymph node enlargement and lymph node metastases with an accuracy of 91%. Reliable differentiation between lymphoma and metastases was not possible. Tuberculous lymph nodes and cysts showed significantly reduced resistance and pulsatile index when compared with metastases. Further information on the type of disease was obtained from the perfusion patterns. Reactive lymph nodes showed increased central perfusion of the hilum, whereas metastases tended to show increased peripheral perfusion.