PURPOSE: The ultrasonic transducer enables blood flow visualization by power Doppler mode. There is no doubt that power Doppler improves visualization to distinguish between vesseles and other aechoic structures. Another merit of power Doppler is to visualize vessels in a lymph node. In my initial experiences, metastatic lymph nodes of lung cancer had irregularly winded vessels in lymph nodes, and sarcoidosis and malignant lymphoma had straight vessels in the lymph nodes and linear margin of the lymph node.
METHODS: 71 lymph nodes of mediastinum or hillum were evaluated in a prospective open study. The bronchoscope with the convex probe (BF-UC260F, 7.5MHz, convex type, OLYMPUS) was used and images by this ultrasonic probe were recorded in digital videos and still images.We evaluated whether there was a linear margin of the lymph node or not, and whether vessels in the lymph node were straight or winded irregularly. We classified these cases by ultrasonic images using these particulars.
RESULTS: 10 lymph nodes (8 sarcoidosis, 2 malignant lymphoma, 0 metastatic lymph node) had linear margin of the lymph node and straight vessels in the lymph nodes. 61 lymph nodes (1 sarcoidosis, 1 malignant lymphoma, 59 metastatic lymph nodes) had not linear margin of the lymph node. In these 61 lymph nodes, 56 of 59 metastatic lymph nodes had irregularly winded vessels in lymph nodes.
CONCLUSION: Irregularly winded vessels were a diagnostic factor for metastatic lymph nodes, and linear margin of the lymph node plus straight vessels were diagnostic factors for sarcoidosis and malignant lymphoma.
CLINICAL IMPLICATIONS: The ultrasonic images of B-mode and power Doppler mode are useful to diagnose mediastinal and hilar lymph nodes.
DISCLOSURE: Noriaki Kurimoto, No Financial Disclosure Information; No Product/Research Disclosure Information