The purpose of this study was to evaluate the usefulness of power Doppler sonography to detect possible differences in blood flow patterns between malignant and benign cervical lymph nodes. We performed preoperative power Doppler sonography in 63 patients with squamous cell carcinoma of the oral cavity and detected 116 nodes. Sixty-nine of the nodes were considerd to be malignant adenopathy according to their size, shape, boundary and internal echos and we performed histopathological examination. The other 47 nodes couldn't be made pathological finding because they were clearly benign lymph nodes. Based on the power Doppler findings, 5 vascular patterns were identified: Type 1 (absent vascularity), Type 2 (spot pattern vascularity in the node), Type 3 (hypertrophic vascular pole in the node), Type 4 (peripheral vascularity of the node), and Type 5 (central hilar vascularity). The vascularity index was defined as number of colored pixels that expressed blood flow signals. Of the 116 nodes, 35 nodes were classified into Type 5 and were nonmetastatic lymph nodes. Type 1, Type 2, Type 3 and Type 4 were predominantly found in the metastatic lymph nodes. Fifteen of the 62 (24.2 %) metastatic lymph nodes and 10 of the 54 (18.5 %) nonmetastatic lymph nodes were classified into Type 1. The vascularity index on power Doppler images of metastatic lymph nodes was significantly higher than nonmetastatic lymph nodes (p<0.05) . However, no significant correlations were found between the size of lymph nodes and the vascularity index. The results suggest that typical vascular patterns and the vasculary index determined by power Doppler sonography are helpful to differentiate between benign and malignant adenopathy.
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