[Extracapsular spread of cervical lymph node metastases: diagnostic relevance of ultrasound examinations]

Assessment of the value of ultrasound examination in the determination of extracapsular neoplastic infiltration and soft tissue infiltration of cervical lymph nodes.

In a prospective study the results of ultrasound studies in 110 patients with squamous cell carcinoma in the head-neck region were compared with the findings of the histologic examination after neck dissection.

Ultrasound examination showed a specificity of 81.8 % in the determination of extracapsular neoplastic infiltration. The sensitivity was only 78.6 % - this was mainly caused by microscopic extracapsular growth, which gave false-negative results. Infiltration of blood vessels were identified in all patients. There was only one false negative diagnosis of muscle infiltration.

The specificity (81.8 %) and sensitivity (78.6 %) of ultrasound examinations in the diagnosis of extracapsular infiltration in patients with lymph nodes metastasis is promising. But the examiner has to keep in mind that especially microscopic extracapsular neoplastic infiltration cannot be seen in ultrasound.