[Doppler color in superficial adenopathies].
BACKGROUND
Superficial lymph nodes are frequently involved in different diseases. Their location makes them suitable for effective assessment with high-resolution US and color Doppler has been recently suggested as a tool for increasing sensitivity in lymph node studies. Thus, we investigated the main vascular patterns detectable in abnormal superficial lymph nodes.


METHODS
We evaluated 260 nodes in 180 adult patients; the nodes were located in the cervicofacial ring (78, 30%), internal jugular stations (104, 40%), and supraclavicular (44, 17%), axillary (21, 8%), and inguinal (13, 5%) stations. Color Doppler was performed with 7.5-13 MHz linear transducers, with parameters adjusted for slow-flow detection (5-6 MHz frequency, 700-900 Hz PRF, 50 Hz band filter, high color persistence). Disease assessment required fine-needle biopsy (95 nodes in 95 patients) and clinical follow-up (165 nodes in 85 patients).


RESULTS
Fifty-five nodes (21%) presented acute and 130 (50%) chronic inflammation: 75 nodes (29%) were metastatic. The following vascular patterns were detected: a single vascular pole (type I) was seen in chronic inflammation (72% sensitivity, 86% specificity, 57% positive and 92% negative predictive value); an enlarged single vascular pole, with 2-3 enlarged branches (type II) in acute adenitis (80% sensitivity, 81% specificity, 78% positive and 83% negative predictive value); multiple vascular poles with many deformed and displaced branches converging centrally (type III) in metastases (76% sensitivity, 100% specificity, 100% positive and 91% negative predictive value).


CONCLUSIONS
We conclude that color and power Doppler are useful integrations to B-mode US because they can detect specific signs of malignancy such as peripheral vascular poles and intranodal displacement of vessels.
Giovagnorio
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I Cattedra di Radiologia, Università La Sapienza, Roma. giovagnorio@axrma.uniroma1.it
D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008875:Middle Aged; D018615:Ultrasonography, Doppler, Color
Il color Doppler nelle adenopatie superficiali.