Abstract
To diagnose the metastatic involvement of cervical lymph nodes, preoperative clinical examinations, x-ray CT, and 10 MHz high-resolution ultrasonography were performed on 24 patients with oral squamous cell carcinomas who underwent radical neck dissections between April 1991 and October 1993. The findings were correlated with the histopathological findings involving neck lymph nodes. With ultrasonography, lymph nodes with a minimal axial diameter of 8 mm or more, or those with abnormal hyperechoic areas were dianosed as positive for metastasis. The accuracy of ultrasonography per case was 96%, which was superior to rates of 75% with clinical examination and 88% with CT diagnosis. With ultrasonography, the sensitivity, specificity, and accuracy per node were 86%, 96%, and 93%, respectively. Of 56 pathological metastatic lymph nodes, 16 nodes with a minimal axial diameter of less than 8 mm were correctly diagnosed as a result of the presence of abnormal internal echoes.
In conclusion, in addition to size, the internal echoes of lymph nodes should be included in the criteria for diagnosing lymph node metastases.
