Article Figures & Data
Figures
- Fig 1.
Images from the case of an 83-year-old woman with upper gingival cancer.
A, Contrast-enhanced axial CT scan shows reactive node (arrow; short-axis diameter, 4 mm) in level I.
B, Gray scale sonogram of the same node as that shown in A shows reactive node exhibiting normal hilar echogenicity (arrows).
C, Doppler sonogram shows blood flow signals (arrow) overlapping hilar echogenicity.
D, Contrast-enhanced axial CT scan, obtained 10 months after the examinations that produced negative results (shown in A–C), shows metastatic node (arrow; short-axis diameter, 8 mm) exhibiting central nodal necrosis.
E, Gray scale sonogram of the same node as that shown in D shows metastatic node without hilar echogenicity.
F, Doppler sonogram shows abnormal blood flow signals in periphery (arrows). No hilar blood flow signal intensity is seen.
Tables
CT criteria Size criteria Level of the neck Short-axis diameter cut-off point I ≥8 mm II ≥9 mm III ≥6 mm IV ≥7 mm Internal architecture Central nodal necrosis Sonographic criteria Internal architecture No hilar echo or hilar blood flow A node is metastatic if it fulfills the CT criteria (size or internal architecture or both) plus the sonographic criteria - TABLE 2:
Performance of combined criteria of helical CT and Doppler sonography for 17 patients with recurrent cancer in the cervical lymph nodes
Lymph nodes (n=255) No. of metastasis 30 No. of reactive nodes 225 Combination CT Sonography No. of false positive nodes 0 5 13 No. of false negative nodes 2 3 2 Sensitivity (%) 87 83 87 Specificity (%) 100 97 94 Positive predictive value (%) 100 87 67 Negative predictive value (%) 99 99 99
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