title: Real-time tissue elastography for the diagnosis of lymph node metastasis in oral squamous cell carcinoma.
abstract: We compared conventional ultrasound (US) B-mode, color Doppler and elastographic assessment of lymph node (LN) stiffness against pathological findings from surgical samples, to determine the most useful factors for identifying LN metastases. Seventy-one LNs in 19 patients with oral squamous cell carcinoma (OSCC) were examined. Using our new system, elastography images were scored from 1-5. The score 1-4 were correlated with the blue area of each LN, which indicated increased stiffness: (1) none; (2) < 50%; (3) 50%; or (4) > 50%. A score 5 indicated central necrosis and did not correlate with the blue area. We found significant differences in minimal diameter, shape index, margin, internal structure, hilus presence or absence, elastography score and percentage of blue area between metastatic and nonmetastatic LNs. Stepwise regression analysis identified elastography score 3-5 as an independent significant LN metastatic factor, suggesting that our scoring system may be useful for accurately diagnosing metastatic LNs.
authors.affiliation: Oral and Maxillofacial Surgery, Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan. greened_amethyst829@hotmail.com
authors.forename: Naomi
authors.initials: N
authors.lastname: Ishibashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamagata
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Kahori
authors.initials: K
authors.lastname: Seto
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Shinya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Keiji
authors.initials: K
authors.lastname: Shinozuka
authors.forename: Toru
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Kojiro
authors.initials: K
authors.lastname: Onizawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Bukawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary*; D003199:Computer Systems; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity