斉藤 泰博, 山田 有則, 片田 竜司, 後藤 卓美, 遠山 節子, 峯田 昌之, 吉川 大平, 油野 民雄

Yasuhiro SAITOH, Tomonori YAMADA, Ryuji KATADA, Takumi GOTOH, Setsuko TOHYAMA, Masayuki MINETA, Daihei YOSHIKAWA, Tamio ABURANO

旭川医科大学放射線科

Department of Radiology, Asahikawa Medical University

キーワード : Lymph node, Neck, Power mode, Pulsed Doppler method, Ultrasound

Fifty-two patients with 111 histologically confirmed enlarged cervical lymph nodes, comprising 23 lymph nodes of malignant lymphoma, 49 metastatic lymph nodes, and 39 benign lymph nodes, were studied using power Doppler imaging and the pulsed Doppler mode. We classified the color signals obtained from these lymph nodes with power mode into four patterns: (A) hilar, (B) network, (C) marginal, and (D) negative. These signals were detected in 100% of the malignant lymphomas and benign lymph nodes, and in 83.7% of the metastatic lymph nodes. All cases of malignant lymphoma and most of the benign lymph nodes showed pattern A; metastatic lymph nodes showed all four signal patterns. Histologic investigation of the metastatic lymph nodes showed that all four signal patterns were produced in almost equal proportions by squamous cell carcinomas, whereas thyroid carcinomas produced mainly pattern B. In terms of the relationship between the power Doppler signal pattern and internal echo pattern, almost all instances of homogeneous or eccentric high echo pattern were signal pattern A, while instances of heterogeneous or sonolucent echo pattern showed all four signal patterns. The pulsed Doppler mode produced significantly higher PI and RI values in malignant lymphomas and metastatic lymph nodes than in benign lymph nodes. Furthermore, there was a significant positive correlation between lymph-node diameter and velocity indices obtained with FFT analysis only in malignant lymphomas. We conclude that ultrasonographic evaluation with power Doppler imaging and the pulsed Doppler mode is useful in adjunctive diagnosis of enlarged cervical lymph nodes.