3D Ultrasound Examination of the Superficial Lymph Nodes - Does it Provide Additional Information?

 

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Zusammenfassung

Ziel: Vergleich der oberflächlichen Lymphknoten im standardzweidimensionalen (2D-)Ultraschall und dreidimensionalen (3D-)Ultraschall. Material und Methoden: Zweiundfünfzig Lymphknoten (35 zervikal, 16 axillar, 1 inguinal) bei 52 Patienten wurden im Ultraschall mit Applikation der 3D-Methode untersucht. Die Gestalt der Lymphknoten und Lymphknotenhili wurde in der Standard-2D- Untersuchung und in der C-Ebene der 3D-Methode (parallel zur Schallkopfoberfläche) beurteilt. Die Ergebnisse der Histopathologie deckte 36 Lymphome, 11 reaktive oder entzündliche Lymphknoten, 3 Metastasen und 2 Plasmozytominfiltrationen auf. Ergebnisse: Die Gestalt der Lymphknotenhili änderte sich in der C-Ebene der 3D-Untersuchung in 28 % und die Gestalt der Lymphknoten selbst bei 37 %. Der Unterschied in der Gestalt der Lymphknoten betraf 45 % der reaktiven oder entzündlichen Lymphknoten und 39 % der Lymphome, während sich die Gestalt der Lymphknotenhili bei 56 % der reaktiven oder entzündlichen Lymphknoten und bei 20 % der Lymphome anders darstellte. Schlussfolgerung: Die C-Ebene der dreidimensionalen Ultraschalluntersuchung der Lymphknoten kann im Vergleich zur Standard-2D-Untersuchung verschiedene Zusatzinformationen zur Gestalt der Lymphknoten und Gestalt der Lymphknotenhili liefern. Die Änderungen der Gestalt betrafen sowohl die Lymphome als auch die reaktiven und entzündlichen veränderten Lymphknoten. Die definitive klinische Relevanz der 3D-Sonographie erfordert weitere Forschungen.

Abstract

Purpose: To compare the appearance of superficial lymph nodes on standard two-dimensional (2D) ultrasound examination and on three-dimensional (3D) ultrasound examination. Materials and Methods: Fifty two lymph nodes (35 cervical, 16 axillary, 1 inguinal) in 52 patients were examined with ultrasound in 3D mode. In standard 2D grey-scale examination and on a C-plane of 3D mode (parallel to the surface of the probe), the shape of a lymph node and its hilum were assessed. Final histopathological diagnoses included 36 lymphomas, 11 reactive or inflammatory lymph nodes, 3 metastases and 2 plasmocytoma infiltrations. Results: The appearance of hilums and lymph nodes as a whole changed on a C-plane of 3D mode (as compared with 2D presentation) in 28 % and 37 %, respectively. The differences in lymph node shape on 2D and 3D ultrasound were apparent in a comparable percentage of reactive lymph nodes (45 %) and lymphomatous lymph nodes (39 %). The differences in lymph node hilum shape on 2D and 3D ultrasound applied to 56 % of reactive lymph nodes and 20 % of lymphomatous lymph nodes. Conclusion: Three-dimensional imaging on a C-plane (parallel to the surface of the probe) may supply the examiner with different information concerning the shape of the lymph node and its hilum in comparison to standard 2D ultrasound. Changes in the shapes of hilum and lymph node occurred in reactive or inflamed lymph nodes as well as in lymphomas. Clinical significance of this fact demands further investigation.

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Ewa Bialek, MD, PhD

Department of Diagnostic Imaging, Brodnowski Hospital

ul. Kondratowicza 8

03-242 Warsaw

Poland

Phone: ++48/22/3 26 58 10

Fax: ++48/22/3 26 59 91

Email: ebialek@amwaw.edu.pl