[Signal-enhanced color-coded duplex sonography of reactively and metastatically enlarged lymph nodes]

Prospective comparison of B-mode-, plain and signal-enhanced colour Doppler ultrasound to evaluate new criteria for assessment of the tumour status of enlarged cervical lymph nodes.

Colour Doppler sonography was performed before and after application of d-galactose in 35 patients with suspected lymph node metastases of the neck. Sonomorphology was analysed qualitatively, maximal flow rate, pulsatility index and resistance index were determined quantitatively.

Signal enhanced Doppler revealed a typical vessel morphology of the lymph nodes facilitating differential diagnosis. In 23%, vascularisation of the lymph nodes was only visible after application of the signal-enhancing agent (benign: 44%, malignant: 5%). The measurement of flow velocity and the calculation of RI and PI did not lead to a reliable differentiation between malignant and benign lymph nodes whereas B-mode sonography yielded highly valid results.

The application of d-galactose facilitates differentiation between malignant and benign lymph nodes.