SIGNAL-ENHANCED COLOR-CODED DUPLEX SONOGR APHY OF REACTIVELY AND METASTATICALLY ENLARGED LYMPH-NODES

Purpose: Prospective comparison of B-mode-, plain and signal-enhanced colour Doppler ultrasound to evaluate new criteria for assessment of t he tumour status of enlarged cervical lymph nodes. Methods: Colour Dop pler sonography was performed before and after application of d-galact ose in 35 patients with suspected lymph node metastases of the neck. S onomorphology was analysed qualitatively, maximal flow rate, pulsatili ty index and resistance index were determined quantitatively. Results: Signal enhanced Doppler revealed a typical vessel morphology of the l ymph nodes facilitating differential diagnosis. In 23 %, vascularisati on of the lymph nodes was only visible after application of the signal -enhancing agent (benign: 44 %, malignant: 5 %), The measurement of fl ow velocity and the calculation of RI and PI did not lead to a reliabl e differentiation between malignant and benign lymph nodes whereas B-m ode sonography yielded highly valid results, Conclusion: The applicati on of d-galactose facilitates differentiation between malignant and be nign lymph nodes.