Contribution of Doppler Sonography Blood Flow Information to the Diagnosis of Metastatic Cervical Nodes in Patients with Head and Neck Cancer: Assessment in Relation to Anatomic Levels of the Neck
Koichi Yonetsua,
Misa Sumia,
Masahiro Izumia,
Masafumi Ohkia,
Sato Eidaa and
Takashi Nakamura
,a
a From the Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry (K.Y., M.S., M.I., S.E., T.N.) and the Department of General Education, School of Health Sciences, Kyushu University (M.O.).
View larger version (49K):
[in a new window]
|
FIG 1. Schematic representation of neck levels I through IV for the classification of cervical lymph nodes. SMG, submandibular gland; DGM, digastric muscle; HB, hyoid bone; OHM, omohyoid muscle; SCMM, sternocleidomastoid muscle; TM, trapezius muscle; CCA, common carotid artery; CL, clavicle
| |
View larger version (159K):
[in a new window]
|
FIG 2. Sonogram shows definition of the short-axis diameter (arrow) of a node
| |
View larger version (68K):
[in a new window]
|
FIG 3. Doppler sonographic features of reactive (A–C) and metastatic (D–F) nodes located at level I (A, D), level II (B, E), and level III+IV (C, F). Arrows indicate normal hilar blood flow.
A, Reactive node (7 mm in short-axis diameter) in 55-year-old man with squamous cell carcinoma of lower gingiva shows normal hilar blood flow.
B, Reactive node (8 mm in short-axis diameter) in 66-year-old man with squamous cell carcinoma of soft palate shows normal hilar blood flow.
C, Reactive node (6 mm in short-axis diameter) in 64-year-old man with squamous cell carcinoma of lower gingiva shows normal hilar blood flow.
D, Absence of normal hilar blood flow and presence of parenchymal flow in a metastatic node (7 mm in short-axis diameter) in a 48-year-old man with squamous cell carcinoma of the tongue.
E, Absence of normal hilar blood flow and presence of parenchymal flow in a metastatic node (8 mm in short-axis diameter) in a 53-year-old man with squamous cell carcinoma of the hypopharynx.
F, Absence of normal hilar blood flow in a metastatic node (5 mm in short-axis diameter) in a 49-year-old man with squamous cell carcinoma of the upper gingiva.
| |
