Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
Int J Clin Oncol. 2010 Feb;15(1):23-32. doi: 10.1007/s10147-009-0017-1. Epub 2010 Jan 29.
Ultrasonographic diagnostic criteria were established to detect cervical metastatic lymph nodes including those up to 10 mm in thickness. Ultrasonography can diagnose not only cervical metastatic lymph nodes but can also be used to evaluate treatment-induced changes in lymph node metastases, one by one or degeneration of metastatic lesion in remaining lymph nodes after chemoradiotherapy.
A high-frequency probe of 7.5 MHz or higher was used in the ultrasonographic diagnosis of cervical lymph node metastases, using B-mode, Doppler blood flow imaging, and tissue elasticity imaging. Cervical lymph node metastases of head and neck squamous cell carcinoma were diagnosed according to ultrasonographic lymph node metastasis criteria. These criteria consist of the thickness of a lymph node (more than 6 mm or not), and existence of intra-lymph nodal occupying lesions suspected as a metastatic focus or not. Furthermore, metastatic lymph nodes remaining without regression after chemoradiotherapy were also evaluated according to therapeutic effect, using ultrasonography, and we examined the efficacy of ultrasonography to predict clinical outcomes.
These diagnostic criteria enabled the accurate diagnosis of metastatic lymph nodes that were up to 10-mm-thick; such nodes are difficult to diagnose by computed tomography (CT) or magnetic resonance imaging (MRI). Moreover, examination of therapeutic effects such as decreased blood flow into a metastatic focus, and softening of a lymph node, by evaluating B-mode dynamic images or employing tissue elasticity imaging, was also useful to determine the effectiveness of chemoradiotherapy and a favorable outcome.
Ultrasonographic diagnostic criteria for cervical metastatic lymph nodes enabled accurate diagnosis. Ultrasonographic evaluation of therapeutic effects on cervical lymph node metastases revealed not only the control of metastasis in the cervical region but also the clinical course and control of the primary site.
超声诊断标准的建立旨在检测包括厚度达 10 毫米的颈部转移性淋巴结。超声不仅可以诊断颈部转移性淋巴结，还可以用于评估治疗引起的淋巴结转移的变化，逐个评估或评估放化疗后残留淋巴结中转移性病变的消退。
使用 7.5MHz 或更高频率的高频探头进行颈部淋巴结转移的超声诊断，使用 B 模式、多普勒血流成像和组织弹性成像。根据超声淋巴结转移标准诊断头颈部鳞状细胞癌的颈部淋巴结转移。这些标准包括淋巴结的厚度（大于 6 毫米或不），以及是否存在可疑为转移灶的淋巴结内占位病变。此外，还根据超声检查评估放化疗后无消退的转移性淋巴结的治疗效果，并检查超声预测临床结局的效果。
这些诊断标准能够准确诊断厚度达 10 毫米的转移性淋巴结；这些淋巴结很难通过计算机断层扫描（CT）或磁共振成像（MRI）诊断。此外，通过评估 B 模式动态图像或使用组织弹性成像检查转移灶血流减少和淋巴结变软等治疗效果，也有助于确定放化疗的效果和良好的结局。
颈部转移性淋巴结的超声诊断标准能够进行准确的诊断。对颈部淋巴结转移的治疗效果进行超声评估，不仅可以显示颈部区域转移的控制情况，还可以显示原发部位的临床过程和控制情况。
