Signal-enhanced colour-coded duplex sonography of reactively and metastatically enlarged lymph nodes.

Purpose: Prospective comparison of B-mode-, plain and signal-enhanced colour Doppler ultrasound to evaluate new criteria for assessment of the tumour status of enlarged cervical lymph nodes. Methods: Colour Doppler sonography was performed before and after application of d-galactose in 35 patients with suspected lymph node metastases of the neck. Sonomorphology was analysed qualitatively, maximal flow rate, pulsatility index and resistance index were determined quantitatively. Results: Signal enhanced Doppler revealed a typical vessel morphology of the lymph nodes facilitating differential diagnosis. In 23 %, vascularisation of the lymph nodes was only visible after application of the signal-enhancing agent (benign: 44 %, malignant: 5 %), The measurement of flow velocity and the calculation of RI and PI did not lead to a reliable differentiation between malignant and benign lymph nodes whereas B-mode sonography yielded highly valid results, Conclusion: The application of d-galactose facilitates differentiation between malignant and benign lymph nodes.