Multivariate Feature Analysis of Sonographic Findings of Metastatic Cervical Lymph Nodes: Contribution of Blood Flow Features Revealed by Power Doppler Sonography for Predicting Metastasis
Toru Chikuia,
Koichi Yonetsua and
Takashi Nakamura
,a
a From the Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan.
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FIG 1. Case of a 61-year-old man with squamous cell carcinoma of the hard palate.
A, Gray-scale sonogram of a reactive cervical lymph node shows homogeneous and low echogenicity of the parenchyma and normal hilar echoes (arrows).
B, Power Doppler sonogram of the same node as that shown in panel A shows a normal reactive hilar blood flow.
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FIG 2. Case of a 53-year-old man with squamous cell carcinoma of the hypopharynx.
A, Gray-scale sonogram of a metastatic cervical lymph node shows abnormal, heterogeneous echogenicity of the parenchyma.
B, Power Doppler sonogram of the same node as that shown in panel A shows abnormal parenchymal blood flow, characteristic of metastasis.
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FIG 3. Sonograms of a reactive node from a 54-year-old man with squamous cell carcinoma of the larynx (A) and a metastatic node from 64-year-old man with squamous cell carcinoma of the hypopharynx (B) show a preferential increase in short axis diameter of the metastatic node.
A, Gray-scale sonogram shows reactive cervical lymph node with relatively flat shape. Arrows indicate hilum.
B, Gray-scale sonogram shows metastatic cervical lymph node. Note that the lymph nodes in panels A and B exhibit similar longitudinal axis lengths, but that the metastatic node in B has a greater short axis length. The metastatic node also shows a focal area of necrosis (arrows).
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FIG 4. Case of a 66-year-old man with squamous cell carcinoma of the upper gingiva. This case shows the value of the presence of hilar echoes over that of increased short axis diameter. The presence of normal hilar flow as detected by Doppler sonography is helpful for confirming the presence of normal hilar echoes.
A, Gray-scale sonogram of a reactive cervical lymph. The short axis length is increased, suggestive of metastatic node; however, the normal hilar echo is present (arrows).
B, Power Doppler sonogram of the same reactive node as that shown in panel A shows a normal hilar flow (arrows).
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