1997 Volume 43 Issue 2 Pages 71-78
This study was conducted to establish objective criteria for the ultrasonographic diagnosis of cervical metastatic lymph nodes (LNs). Materials consisted of 106 LNs removed from 41 patients with squamous cell carcinoma of the oral and maxillofacial region. These LNs were ultrasonographically and histologically examined. B-mode ultrasonograms revealed statistically significant differences in the depth, width, depth and width ratio, edge definition, margin, intensity and heterogeneity of internal echoes, and nodal hilus between the metastatic and the non-metastatic LNs. Color Doppler echograms obtained from 31 of the 106 LNs showed a peripheral perfusion pattern in many metastatic LNs, whereas a central perfusion pattern was seen in many non-metastatic LNs. To ultrasonographically establish objective criteria for metastatic LNs, the correlation between the B-mode ultrasonographic findings and histologic features was analyzed for all LNs. The following regression equation was calculated by multiple logistic regression analysis. Y=1/1+e-λ (Y: metastasis, λ: predictive value=-7.5709+4.2423X1+1.9354X2 +0.5507X3, X1: nodal hilus, X2: intensity of internal echoes, X3: depth).
This equation showed that the sensitivity, specificity, and accuracy, for the metastatic LNs were 82.1%, 92.5%, and 88.7%, respectively. The results suggested that this equation is valuable in the ultrasonographic prediction of metastatic LNs.
