Doppler

Cancer Imaging (2008) 8, 48—56 DOI: 10.1102/1470-7330.2008.0006

REVIEW Ultrasound of malignant cervical lymph nodes
A.T. Ahujaa, M. Yingb, S.Y. Hoa, G. Antonioa, Y.P. Leea, A.D. Kinga and K.T. Wonga Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; and bDepartment of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China Corresponding address: Dr Anil T. Ahuja, Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories Hong Kong SAR, China. Email: [e-mail] Date accepted for publication 21 January 2008 Abstract Malignant lymph nodes in the neck include metastases and lymphoma. Cervical nodal metastases are common in patients with head and neck cancers, and their assessment is important as it affects treatment planning and prognosis. Neck nodes are also a common site of lymphomatous involvement and an accurate diagnosis is essential as its treatment differs from other causes of neck lymphadenopathy. On ultrasound, grey scale sonography helps to evaluate nodal morphology, whilst power Doppler sonography is used to assess the vascular pattern. Grey scale sonographic features that help to identify metastatic and lymphomatous lymph nodes include size, shape and internal architecture (loss of hilar architecture, presence of intranodal necrosis and calcification). Soft tissue oedema and nodal matting are additional grey scale features seen in tuberculous nodes or in nodes that have been previously irradiated. Power Doppler sonography evaluates the vascular pattern of nodes and helps to identify the malignant nodes. In addition, serial monitoring of nodal size and vascularity are useful features in the assessment of treatment response.
Keywords: Cervical lymph nodes; metastases; lymphoma; ultrasound.
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