Abstract
Purpose: The purposes of this study were to show our protocol of diagnostic imaging using CT and ultrasonography and to evaluate the diagnostic accuracy for cervical lymph node metastasis in oral squamous cell carcinoma.
Material and Methods: CT and/or ultrasonography of 147 patients were evaluated retrospectively. Lymph nodes were confirmed pathologically whether metastasis or non-metastasis. The detection ratio, enhanced pattern and short diameter of lymphadenopathy were analyzed on CT. Internal echoes such as hilus and parenchymal echoes, the short diameter, long diameter and the long to short diameter ratio (S/L ratio) were evaluated on ultrasonography.
Results: Ten percent of lymphadenopathy, which was confirmed pathologically as metastasis, was not found on CT. Heterogeneous or rim-enhanced pattern was presented in 50.9% of metastasis and only 4.5% of non-metastasis cases on CT. Strong parenchymal echo pattern was shown in 56.9% of metastasis cases. On the other hand, 66.5% of non-metastasis cases showed a hilus but strong parenchymal echoes. Under the circumstances where lymph nodes had neither hilus nor strong parenchymal echoes, but were 10 mm or more in short diameter, 27.4% were shown in metastasis and only 3.0% in non-metastasis cases. Futhermore, under the circumstances where lymph nodes had neither hilus nor strong parenchymal echoes, but were 3.5 or more in S/L ratio, only 1.5% were shown in metastasis and 13.5% in non-metastasis cases.
Conclusion: On basis of the results of this study, it was suggested that criteria for cervical metastasis using CT and ultrasonography in which“Questionable only on diagnostic imagings”be included. It was considered that this criteria is clinically useful.
