ULTRASONO-ANATOMY FOR EVALUATION OF THE LOCAL LYMPHATIC GROUPS OF THEMAMMA

Sonography has been established as an important adjunct to current dia gnostic techniques for the assessment of mammary lymph nodes. Although this method is widely used, no reproducible standard procedure which is equally applicable to the examination of all relevant lymphatic gro ups has been developed to date. Healthy subjects (n=50) were examined in an attempt at defining sonographic scanning levels for optimum visu alization of anatomic reference landmarks. Images were acquired with a 7.5-MHz linear-array transducer. Anatomic cross-sections of the same level as imaged by sonography were used to identify important details. Unique structures close to the lymph nodes could be identified by son ography, it was not possible, however, to differentiate normal lymph n odes. The correct assessment of lymph drainage areas is therefore poss ible only if the sonographic level is clearly defined and if the exami ner is familiar with the topographic relationships between the depicte d structures. By presenting a reproducible examination technique as we ll as anatomic details, this study aims at avoiding false interpretati ons and increasing the efficacy of sonographic exploration. The author s believe that this simple and hardly time-consuming technique can con tribute to a comprehensive evaluation of the lymph drainage areas of t he breast.