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Journal of Medical Ultrasonics

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1995 - Vol.22

Vol.22 No.08

Original Article(原著)

(0601 - 0610)


Ultrasonographic Evaluation Of Cervical Lymph-Node Metastasis

斉藤 泰博1, 山田 有則1, 吉川 大平1, 川口 香織1, 峯田 昌之1, 秀毛 範至1, 高塩 哲也1, 吉田 弘1, 油野 民雄1, 鳥谷部 純行2

Yasuhiro SAITOH1, Tomonori YAMADA1, Daihei YOSHIKAWA1, Kaori KAWAGUCHI1, Masayuki MINETA1, Noriyuki SHUKE1, Tetsuya TAKASHIO1, Hiroshi YOSHIDA1, Tamio ABURANO1, Naoyuki TORIYABE2

1旭川医科大学放射線科, 2旭川医科大学口腔外科

1Department of Radiology, Asahikawa Medical College, 2Department of Oral Surgery, Asahikawa Medical College

キーワード : Lymph node, Metastasis, Neck, Ultrasonography

We investigated the usefulness of ultrasonography (US) in determining the presence or absence of cervical lymph-node (LN) metastasis. One hundred sixty-nine LNs that had been diagnosed from histopathologic findings from 47 patients with cervical LN metastasis mainly from cancer of the head and neck, were examined. Size, border, and internal echo of the LNs were evaluated on US examination. LN size greater than 10 mm in shortest diameter was a more effective criterion than longest diameter or shortest/longest diameter ratio. Borders were unclear or irregular in 6% of the cases with LN metastasis, though none of the LNs without metastasis had irregular borders. We classified internal echo of LNs into six patterns: homogeneous low (HL), homogeneous high (HH), heterogeneous (HG), central high (CH), eccentric high (EH), or cystic echo (CE) patterns. The HH, HG, and CE patterns were seen mainly in matastatic LNs; the EH pattern, in nonmetastatic LNs. CH and HL patterns were produced by both metastatic and nonmetastatic LNs. While the ratio of HG, and CE patterns increased with length of the shortest diameter, the ratio of the HL pattern tended to decrease. Pathologically, the CE pattern occurred in metastatic LNs, primarily those associated with papillary carcinomas. In the US and corresponding histopathologic findings, echogenic areas in HH, HG, and CH patterns were found to be caused by coagulation necrosis, fibrosis, or keratinization. The eccentric hyperechoic area of nonmetastatic LNs was attributed to fatty tissue. US examination was useful in the diagnosis of metastatic LNs in the cervical region.