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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We divided lymph nodes into three groups, those that are normal, those with lymphadenitis, and those that are metastatic. We analyzed these groups based on their ultrasonographic images by measuring maximum cross-section, L/T ratio, coutour, internal echo images, and posterior echo images, and examined the results statistically. In this study, especially for images relevant to internal echoes, the sound wave reflected from the interior of the lymph nodes was taken as aggregate of bright spots, which were analyzed in terms of the following aspects: texture or size, distribution pattern, and brightness. The results are as follows. (1) The size of the lymph nodes is 7.1 +/- 1.7 mm (mean +/- S.D.) for normal, 10.6 +/- 3.8 mm for lymphadenitis, and 13.1 +/- 7.3 mm for metastatic. (2) The L/T ratio is 0.55 +/- 0.16 for normal, 0.64 +/- 0.21 for lymphadenitis, and 0.83 +/- 0.15 for metastatic. (3) The increment of the lymph node size and the variation in L/T ratio are plotted in the disperation diagram. It was concluded that differential diagnosis would be difficult only based on the size and L/T ratio of the lymph nodes under study. (4) The contour appears indistinct in normal lymph nodes, especially in their lateral aspect, while it is distinct around the whole circumference in lymph nodes with inflammation or metastatic cancer. (5) From the analysis based on texture, distribution, and brightness of the echo images of the interior of lymph nodes, it was concluded that in metastatic lymph nodes, aggregated echoes are distributed unevenly, and their brightness is similar to that of adjacent tissues. 6. Posterior echo images were unique findings that showed acute lymphadenitis. Those analytical results based on the three types of findings were rated and submitted to T-tests, which showed that there is a significant difference at a level of 5% among normal lymph nodes, those with inflammatory changes, and those with metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Differential diagnosis of lymph nodes in oral-maxillary regions by ultrasonography]. 213 3

Normal lymph nodes (l.n.) are elongated and hypoechoic, with central echogenic hilum on B-mode, while color-doppler (CD) shows central hilar vascularization. Chronic inflammatory l.n. are elongated, with echogenic hilum, hilar vascularization on CD and resistance index (RI) 0.60-0.70. Acute lymphadenitis shows intensive hilar flow with RI<0.60; abscess of l.n. is anechoic with through transmission. Tuberculous l.n. are inhomogenously hypoechoic and rounded, with deformed hilar vascularization on CD, occasionally with centripetal flow. They may mimick malignant l.n. on CD due to vessel dislocation by granulomatous masses. L.n. in stage of micrometastasis are of similar structure as reactive l.n., with preserved hilar vascularization; as the metastasis grows, focal cortical expansion and/or destruction of intranodal structure with dislocation and compression of blood vessels may occur; vascular resistance is consecutively increased; in advanced stage of metastatic growth l.n. becomes rounded, hilum is not visible, cortex is heterogenous, occasionally with hyperechoic keratin deposits, unsharp nodal margin is the sign of extranodal neoplastic spread; mainly peripheral vascularization, with fragmentation, deformation and dislocation of intranodal vessels are seen on CD, with increased RI>0.80; necrotic areas are anechoic and avascular on CD. Lymphomatous nodes have preserved internal structure, sharp margins, hypoechoic cortex, frequently with through transmission; large arborized hilum may be displaced; abundant hilar flow is seen on CD, with normal or slightly increased vascular resistance. Although the sensitivity of B-mode and Doppler features of l.n. is mostly limited (false negative rate is significant), high specificity of some of them establishes sonography as a valuable complementary method in differential diagnosis of lymphadenopathy: the presence of hilar vascularization with RI<0.40 accurately indicates acute lymphadenitis, while predominantly peripheral flow pattern and RI>0.80 are typical of metastatic l.n. High enddiastolic velocities (EDV>9 cm/s) are only rarely seen in metastases, while very low EDV<1 cm/s indicates metastatic lymphadenopathy. As sonography is very suitable imaging method for puncture guidance, B-mode and CD analysis of l.n. need to be combined with aspiration cytology whenever possible, as it may considerably improve the accuracy of non-invasive patient diagnostic work-up. Literature on sonography of l.n. was reviewed, and selection of most relevant articles was made.
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PMID:[Doppler ultrasonography of superficial lymph nodes]. 1575 87