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Sonographische Diagnostik vergrößerter Lymphknoten

Pathogenetische Kategorisierung mit der kontrastverstärkten Powerdoppler-Sonographie

Sonography of enlarged lymph nodes

Pathogenetic categorization using contrast enhanced power Doppler sonography

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Zusammenfassung

Hintergrund.

Ziel war die sonographische Kategorisierung vergrößerter oberflächlicher Lymphknoten in benigne und maligne anhand von Morphologie und Vaskularisationsmuster.

Patienten und Methoden.

Es wurden 57 Patienten mit vergrößerten Lymphknoten im B-Modus und anschließend mit kontrastverstärkter Powerdoppler-Sonographie (PDS) nach Morphologie und Gefäßmuster beurteilt und den Gruppen benigne und maligne zugeordnet. Die sonographischen Befunde wurden mit Histologie und Verlaufskontrollen verglichen.

Ergebnisse.

Bei 55 Patienten wurden 40 Lymphknoten korrekt als benigne und 15 Lymphknoten korrekt als maligne eingestuft. Dabei waren Form und Vaskularisationsmuster die beiden zuverlässigsten Kriterien. Entzündlich vergrößerte Lymphknoten zeigten eine über den Hilus erfolgende Gefäßversorgung, metastatisch befallene Lymphknoten über die Kapsel. Zwei Lymphknoten wurden falsch-positiv befundet.

Schlussfolgerung.

B-Modus-Sonographie mit kontrastverstärkter PDS ist eine zuverlässige diagnostische Methode zur Differenzierung und Kategorisierung vergrößerter oberflächlicher Lymphknoten.

Abstract

Background.

The purpose of this study was to categorize enlarged superficial lymph nodes as benign or malignant using sonomorphologic features and vascularization pattern.

Patients and methods.

Enlarged superficial lymph nodes in 57 patients were assessed with B-mode and contrast-enhanced power Doppler sonography. Morphology and vascularization were evaluated. The lymph nodes were categorized as benign or malignant. Correlation was made with histology and follow-up results.

Results.

In 55 patients, 40 lymph nodes were correctly categorized as benign and 15 lymph nodes correctly as malignant. The most reliable criteria were shape and vascularization pattern. Intact hilar vessels and branching indicated benign enlargement, destruction of the hilum with vessels running peripherally along the capsule indicated metastatic destruction. Two benign lymph nodes were considered malignant (false positive).

Conclusion.

B-mode ultrasound along with contrast-enhanced power Doppler ultrasound is an easy, cost-effective, and reliable tool for differentiation and categorization of enlarged superficial lymph nodes.

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Authors and Affiliations

  1. Institut für Radiologie, Universitätsklinikum Schleswig-Holstein – Campus Lübeck, Ratzeburger Allee 160, 23538 , Lübeck

    B. M. Stoeckelhuber, S. A. Berg, J. Gellissen & C. U. Bergmann-Koester

  2. Abteilung für Neuroradiologie, Klinikum Großhadern, Ludwig-Maximilians-Universität München

    M. Wiesmann

  3. Klinik für Dermatologie und Venerologie, Städtisches Krankenhaus Hildesheim

    M. Tronnier

  4. Institut für Anatomie, Ludwig-Maximilians-Universität München

    M. Stoeckelhuber

  5. Institut für Pathologie, Universitätsklinikum Schleswig-Holstein – Campus Lübeck

    S. Krueger

Authors
  1. B. M. Stoeckelhuber
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  2. M. Wiesmann
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  3. S. A. Berg
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  4. M. Tronnier
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  5. M. Stoeckelhuber
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  6. S. Krueger
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  7. J. Gellissen
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  8. C. U. Bergmann-Koester
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Correspondence to B. M. Stoeckelhuber.

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Stoeckelhuber, B.M., Wiesmann, M., Berg, S.A. et al. Sonographische Diagnostik vergrößerter Lymphknoten. Hautarzt 57, 610–617 (2006). https://doi.org/10.1007/s00105-006-1152-5

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  • DOI: https://doi.org/10.1007/s00105-006-1152-5

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