Differentiation of cervical lymph modes by the use of Levovist (R) contrast amplifier in colour duplex sonography.

Aim: Proof of intranodal vessels in lymph nodes of the head and neck region and their association to specific types of vascularisation enables categor ization of lymph nodes and improves preoperative predictability of tissue d ignity. In many lymph nodes imaged by colour duplex sonography no intranoda l vascularisation can be found, The purpose of the study was to find out if sonographic categorisation of lymph nodes, which do not show intranodal Ve ssels in normal colour duplex sonography, is enabled with the contrast ampl ifier Levovist (R). Method: In 30 patients with metastasis in lymph nodes, malignant lymphomas or inflammatory lymph nodes with no or poor intranodal vascularisation, we administered LeVovist (R), a contrast amplifier given i ntravenously, during colour duplex sonography. Results: Intranodal vascular isation could be visualized in all cases by the use of Levovist (R) contras t amplifier during the sonographic investigation. Conclusion: Use of the co ntrast amplifier Levovist (R) leads to an improvement of the categorisation of lymph nodes. Especially inflammatory lymph nodes show more intranodal v essels in the hilus area, whereas metastatic lymph node Vessels show no lin k to the hilus area. Preoperative diagnostic procedures may take advantage of this new technique.