Lymph node metastases of cutaneous melanoma: Diagnosis by B-scan and color Doppler sonography

Improved Differentiation of Benign and Malignant Lymphadenopathy in Patients With Cutaneous Melanoma by Contrast-Enhanced Color Doppler Sonography

“…However, in our study, 1 histologically proven lymph node metastasis and 2 soft tissue metastases did not reveal any vascularity after application of the contrast enhancer. A similar effect was reported by Moehrle et al, 6 who investigated melanoma patients using native CDS. They found the absence of vessels or a reduced perfusion to support the diagnosis of melanoma metastases.…”

“…4,5 Moreover, color Doppler sonography (CDS) has been shown to give additional diagnostic information because of the detection of characteristic vascularization patterns in some, mostly enlarged, malignant and reactive lymphnodes. 6 Thecurrentprospectivestudy was performed to evaluate whether application of a D-galactose-based contrast enhancer, routinely used in cardiology, for example, improved the visualization of vascularization pattern in echo-poor structures suggestive of lymphadenopathy detected by B-mode sonography in patients with cutaneous melanomas. …”

Ultrasonography Using Simple Diagnostic Criteria vs Palpation for the Detection of Regional Lymph Node Metastases of Melanoma

“…15 We did not use color Doppler sonography and the only study to assess its use in patients with melanoma evaluated only patients with palpable nodes. 23 Although most metastatic nodes lacked hilum vessels and showed complete or partial perfusion in this study, their resistance and pulsatility indices were lower than those reported for malignancies other than melanoma, and, because of the overlap between metastatic and nonmetastatic groups, these indices had no diagnostic value. We also did not use the newly developed sonography-enhancing agents that may improve vessel identification.…”

“…7,[9][10][11][12]14,15 In a study including only patients having melanoma with palpable nodes prior to radical LD, the presence of at least 2 of the 3 criteria (Solbiati index Ͻ2, hypoechoic center, and the absence of hilum vessels) yielded 100% sensitivity and 96% specificity for the diagnosis of melanoma metastases. 23 The differential diagnosis of round or slightly oval masses with poor echogenicity also includes lymphoma, necrotic lymph nodes (tuberculosis), and cystic masses. The differential diagnosis of enlarged lymph node includes inflamed lymph nodes.…”

High-Resolution Ultrasound Combined with Power Doppler Sonography Can Reduce the Number of Sentinel Lymph Node Biopsies in Cutaneous Melanoma

“…The value of a combination with Doppler sonography in the characterization of SLN is not clear. Color Doppler sonography in general is known to be helpful in detection of characteristic vascularization patterns, especially in enlarged malignant and reactive lymph nodes [27]. However, evaluation of small vessels with low blood flow in small lymph nodes has limitations, even by power-mode Doppler ultrasound despite its higher sensitivity.…”