Power doppler sonography of cervical lymph nodes in patients with head and neck cancer

The purpose of this study is to evaluate the usefulness of power Doppler sonography in differentiating metastatic from non-metastatic cervical lymph nodes in patients with head and neck cancer. Histologically proved metastatic [n=48] and non-metastatic [n=110] lymph nodes were examined with power Doppler sonography in 52 patients with head and neck cancer. Power Doppler sonography was assessed for its ability to differentiate metastatic from non-metastatic lymph nodes. Power Doppler sonography showed characteristic features of parenchymal blood, flow signal in 40 [84%] of the 48 metastatic lymph nodes. On the Other hand, only two [2%] of the 110 non-metastatic nodes showed these power Doppler signals. In addition, power Doppler sonography showed high levels of sensitivity [83%] and specificity [98%] in depicting metastatic lymph nodes, which were superior to the value [66% sensitivity and 92% specificity] obtained by applying size criteria [L/S ratio: long axis short axis ratio of the enlarged lymph node]. Our results suggest that the power Doppler criteria combined with the size criteria [L/S ratio] constitute a powerful tool in differentiating metastatic from non-metastatic lymph nodes in patients with head and neck cancer

Computed tomography and MRI evaluation of mucoceles of the paranasal sinuses with reference to intracranial and extracranial extensions

15 patients with mucoceles of the paranasal sinuses were studied, the commonest sinus to be involved was the ethmoid followed by the frontal maxillary and spheno-ethmoidal, while sphenoid sinus alone was not involved. All the cases were subjected to computed tomography and only 2 cases were examined by magnetic resonance imaging. CT was usually sufficient for making diagnosis and defining the extent of the lesion, accurately demonstrating the orbital and intracranial extensions by both axial and coronal sections. All cases were explored surgically verifying the extension and the chronicity. MRI was very valuable in detecting the nature of the mucocele by high T2-Wls, while Tl-Wls differed according to the chronicity of the mucocele also MRI by its multiplanner capability demonstrated the extent of the lesion. One drawback of the MRI was its poor demonstration of the bones and calcifications of the sinuses, while high resolution CT demonstrated bone details and intracranial extension better. T2-weighted image and it displays the sinus in 3 plane imaging with direct sagittal sections