A Comparative Study Between US Findings Using High Frequency Transducer and Pathologic Findings of Resected Lymph Nodes from Stomach Cancer Patients.

Kim,  Baek Hyun; Park,  Cheol Min; Kim,  Hyoung Seuk; Cha,  In Ho; Chung,  Kyoo Byung; Suh,  Won Hyuck; Kim,  Chul Hwan; Mok,  Young Jae

Journal of Korean Society of Medical Ultrasound 1997;16(1): 43-52.

Baek Hyun Kim, Cheol Min Park, Hyoung Seuk Kim, In Ho Cha, Kyoo Byung Chung, Won Hyuck Suh, Chul Hwan Kim, Young Jae Mok

¹Department of Diagnostic Radiology, College of Medicine, Korea University, Korea.
²Department of Anatomic Pathology, College of Medicine, Korea University, Korea.
³Department of Surgery, College of Medicine, Korea University, Korea.

Published online: January 1, 2001.

ABSTRACT

PURPOSE: To evaluate the most accurate parameter in differentiating malignant lymph nodes from benign ones, reseated lymph nodes from stomach cancer patients were studied with ultrasonogram using a high frequency transducer. MATERIALS & METHODS: Sixty-seven lymph nodes with possibility of metastases were obtained from 30 patients with stomach cancer. Ultrasonogram was done for each resorted lymph node using a high frequency transducer(10 MHz.) in normal saline with a specially designed gel pad. We measured the long diameter, the short diameter and the ratio of long diameter/short diameter (L/S ratio), and examined the hilar echogenicity for loss or presence of echogenic hilum. We examined the nodes pathologically, and compared with sonographic findings. The nodes were divided into two groups according to the long diameter; those larger than 1 cm were classified as group l(n=45), and those less than 1 cm as group ll(n=22). RESULTS: For in vitro ultrasonogram, the most accurate parameter in differentiating malignant lymph nodes from benign ones was the loss of echogenic hilum (75%). The accuracy of other parameters were as follows; 73% for short diameter > or =1.0cm, 70% for L/S ratio less than 2.67% for long diameter > or =1.5cm, and 55% for long diameter > or = 1.0cm, in decreasing order respectively. The diagnostic accuracy of the loss of echogenic hilum was higher in group l than group ll with 82% accuracy. In addition, a combined new parameter(hilar echogenicity and/or L/S ratio less than 2) had very high accuracy of 87% for malignancy. CONCLUSION: The most accurate parameter in differentiating malignant lymph nodes from benign ones was the loss of echogenic hilum rather than size of the parameters. And also, hilar echogenicity was more important in the lymph nodes larger than 1 cm in long diameter, especially when used in combination with L/S ratio less than 2.

Keywords: Lymphatic system. US; Lymphatic system. neoplasms; Ultrasound(US). comparative studies