Two-dimensional and three-dimensional power Doppler sonographic classification of vascular patterns in cervical lymphadenopathies

Vascular patterns may reflect some pathologic behaviors of tumors and lymph nodes. Power Doppler ultrasonography, with improved sensitivity and better noise contrast, were used to depict vasculature in 289 cases of cervical lymphadenopathy. Four patterns of vasculature, in addition to avascular nodes, were classified. Benign lymphadenopathies represented 89% and 83% of avascular and hilar type nodes, respectively However, malignant lymphadenopathies dominated in nodes that were of spotted (72%), peripheral (60%), and mixed type (80%). Correlation between nodal sizes and chronologic changes of vascular patterns in malignant lymphadenopathies implied a reasonable classification. Three-dimensional power angiography, with the advantage of less plane-sampling bias, was further used to validate our classification.