Abstract：Objective: Sonographic criteria of the lymph node have been found to be good indicators for metastatic lymph nodes. We determined which sonographic features are most predictive of residual-relapse in cervical lymph nodes among patients with post-therapy nasopharyngeal carcinoma. Methods: Power Doppler sonography were analyzed in 179 cervical nodes(114 residual-relapse and 65 reactive nodes) from patients with post-therapeutic nasopharyngeal carcinoma after neck lymph node radical dissection or selective dissection, All cases were proven by post-surgery pathology. The gray-scale sonographic features of the presence or absence of hilar structure, the even or uneven of lymph node echo, short axis length(≥10mm), long axis length, long-short axis ratio(L/S 2), the boundary, the blood flow were evaluated. Multivariate logistic regression analyses were conducted to determine the relative value of each sonographic feature. Results: Multivariate analysis suggested that the absence of hilar structure, increase in short axis length(≥10mm) were the sonographic features for prediction of residual-relapse lymph nodes. Specificity, sensitivity, accuracy and Kappa index was 90.4%, 84.6%, 88.2% and 0.75 for node short axis diameter(≥10mm). 95.6%, 86.5%, 92.1% and 0.82 for the absence of hilar structure. The sonographic features of absence of hilar structure was the better index than the features of short axis diameter(≥10mm). Conclusions: The sonographic criteria most predictive of metastatic cervical lymph nodes were absent hilar structure and increase in short axis length(≥10mm), as assessed by logistic regression analysis. It can be used as an clinical criteria to diagnosis residual-relapse lymph nodes in post-therapy nasopharyngeal carcinoma.
2011, Vol. 22 
