舌癌原発巣と頸部リンパ節転移の超音波診断

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  • 林 孝文
    新潟大学大学院医歯学総合研究科顎顔面放射線学分野

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  • Ultrasonography in tongue squamous cell carcinoma and cervical lymph node metastasis

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Ultrasonography is an inexpensive, convenient, and noninvasive technique that provides real-time imaging with excellent spatial resolution of soft tissue. Ultrasound elastography is a promising method in differentiating malignant from benign in both primary lesion and regional lymph nodes.<br> 　In the current TNM classification(8th edition), depth of invasion(DOI) has been incorporated into T staging in oral tongue squamous cell carcinoma(OTSCC). Histopathologically, DOI is defined as the depth of tumor measured by dropping a“plumb line” to the deepest portion of the tumor from the level of the basement membrane of the normal mucosa closest to the tumor. According to previous reports, intraoral ultrasonography has proven to be useful for the measurement of DOI of OTSCC.<br> 　Ultrasonography is one of the reliable imaging methods currently available for detecting cervical lymph node metastases in patients with OTSCC. In addition to the minimal axial diameter criteria(exceeding 6-8mm),the ultrasonographic features of metastatic lymph nodes are round shape, loss of echogenic hilum, internal heterogeneity(anechoic and/or hyperechoic area), and peripheral vascularity. Periodical follow-up ultrasonography is useful in patients with OTSCC for the detection of subsequent lymph node metastases after treatment of primary lesion.

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