shu-508 and Lymphoma

The application of Power Doppler mode examination introduced the assessment of vascularisation and measurement of blood flow parameters in lymph node's vessels as a differentiating criterion of benign and malignant lymphadenopathy. However, those criteria appeared insufficient in evaluation of the malignancy grade of enlarged lymph nodes, especially in the cases of lymph nodes with invisible or scantly visible vascularisation in Power Doppler mode. Introducing contrast media in ultrasonographic examinations enabling intensification of the Doppler signal even by 20 dB creates the hope of increasing diagnostic efficacy of ultrasonography in evaluation of vascularisation in lymph nodes enlargement. The purpose of the study was to define the usefulness of ultrasonographic contrast media (Levovist), 3D presentation and harmonic imaging in differential diagnosis of lymph nodes enlargement in children. 32 children with cervical lymph nodes enlargement underwent examination with ultrasonography. In the examinations, Levovist by Schering was used in concentration 300, the amount depending on patient's body mass. The analysis of results obtained in the study revealed that application of contrast media enables better visualisation of lymph node vascularisation. Localisation of the vessels which were not shown in conventional Doppler mode enables visualisation of the vessel architecture in the lymph node and better defining of vascularisation pattern. Application of the new methods of THI and 3D imaging and contrast media in Power Doppler examinations increases the diagnostic efficacy of ultrasonography in differentiating lymph nodes alternations.

Topics: Child; Diagnosis, Differential; Humans; Image Enhancement; Imaging, Three-Dimensional; Lymph Nodes; Lymphatic Metastasis; Lymphoma; Neck; Neovascularization, Pathologic; Polysaccharides; Ultrasonography, Doppler, Color

Since the tumor growth depends on the formation of feeding vessels, color/power Doppler ultrasonography (US) has been used to evaluate the vascular flow images of lymph nodes (LNs) in order to differentiate benign LNs from malignant LNs or lymphoma from metastatic carcinoma.. We performed color/power Doppler ultrasonography (US) using Levovist (LV) to evaluate the vascular patterns in the LNs of 10 patients with different types of lymphoma. The patterns were classified as central, peripheral, or avascular type.. Vascular flow was identified in 9 of 10 LNs and it was enhanced with LV in all cases. The vascular pattern of the LNs was of the central type in all seven B-cell lymphoma patients and one of two T-cell lymphoma patients and of the peripheral type in the remaining T-cell lymphoma patient. The avascular type pattern was observed in one Hodgkin lymphoma patient even with LV.. Typical vascular patterns might be associated with certain subtypes of lymphoma, and LV appears to improve the diagnostic value of Doppler US.

Topics: Adult; Aged; Cohort Studies; Contrast Media; Female; Humans; Lymph Nodes; Lymphatic Vessels; Lymphoma; Male; Middle Aged; Polysaccharides; Ultrasonography, Doppler, Color

to analyse whether ultrasound contrast agent (UCA) improves the diagnostic accuracy to differentiate between benign and malignant superficial lymph node enlargement by using colour-coded duplex sonography (CCDS) and power Doppler (PD).. 32 patients with suspected malignant superficial lymph node enlargement prospectively underwent standardised ultrasound examinations using B-mode sonography and native and contrast-enhanced CCDS and PD immediately before biopsy. Solbiati-Index (longitudinal-transverse diameter ratio) and intranodal flow patterns by using different vascularisation types were assessed. Histological and sonographical findings were correlated.. 27 malignant and 5 benign lymph nodes were found. Solbiati-Index was lower in malignant lymph nodes than in benign nodes (mean 1.5 vs. 2.4, P<0.045). More intranodal flow patterns could be detected after UCA (53 vs. 43) but the number of correctly identified malignant nodes decreased after UCA (26 vs. 24) and the number of correctly identified benign nodes remained constant compared with native CCDS and PD. In 31% of the colour-mode studies, PD was considered to visualise more clearly intranodal vascular flow patterns than CCDS.. despite depicting more intranodal vascular patterns, the use of an ultrasound contrast agent seems not to improve the diagnostic value of CCDS and PD compared with native colour-mode studies in superficial lymph node enlargement.

Topics: Adolescent; Adult; Aged; Biopsy, Needle; Contrast Media; Diagnosis, Differential; Female; Humans; Image Enhancement; Lymph Nodes; Lymphadenitis; Lymphatic Metastasis; Lymphoma; Male; Middle Aged; Polysaccharides; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; Tuberculosis, Lymph Node; Ultrasonography, Doppler, Color

Proof of intranodal vessels in lymph nodes of the head and neck region and their association to specific types of vascularisation enables categorization of lymph nodes and improves preoperative predictability of tissue dignity. In many lymph nodes imaged by colour duplex sonography no intranodal vascularisation can be found. The purpose of the study was to find out if sonographic categorisation of lymph nodes, which do not show intranodal vessels in normal colour duplex sonography, is enabled with the contrast amplifier Levovist.. In 30 patients with metastasis in lymph nodes, malignant lymphomas or inflammatory lymph nodes with no or poor intranodal vascularisation, we administered Levovist, a contrast amplifier given intravenously, during colour duplex sonography.. Intranodal vascularisation could be visualized in all cases by the use of Levovist contrast amplifier during the sonographic investigation.. Use of the contrast amplifier Levovist leads to an improvement of the categorisation of lymph nodes. Especially inflammatory lymph nodes show more intranodal vessels in the hilus area, whereas metastatic lymph node vessels show no link to the hilus area. Preoperative diagnostic procedures may take advantage of this new technique.

Topics: Contrast Media; Diagnosis, Differential; Head and Neck Neoplasms; Hodgkin Disease; Humans; Image Enhancement; Lymph Nodes; Lymphadenitis; Lymphatic Metastasis; Lymphoma; Neovascularization, Pathologic; Polysaccharides; Sensitivity and Specificity; Ultrasonography, Doppler, Duplex

The vascularity of cervical lymph nodes can be documented by means of color-coded duplex sonography and malignant and benign lymph nodes distinguished on the basis of typical patterns of vascularity. However, not all intranodal vessels can be visualized by color-coded duplex sonography, and minute vessels are detectable only after the administration of a signal enhancer. This also makes it possible to assess the morphology of cervical lymph nodes that are inaccessible on plain sonography. In the present study we examined acute and chronic inflammatory and metastatic lymph nodes as well as malignant lymphomas to determine the extent to which a specific pattern of vascularity can be detected with color-coded duplex sonography after the injection of Levovist as a signal enhancer. In addition, digital image processing was used to quantify the vascularity detected in relation to the cross-sectional area of the lymph nodes as seen at sonography and to determine whether there are any differences in lymph node types as regards an increase in the detection of vascularity. After injection of the marker a typical pattern of vascularity could be assigned to all lymph nodes examined and differences shown in quantifying vascularity: This increase was greatest in the acutely inflamed lymph nodes (36.0 +/- 5.0%) and smallest in lymph nodes with chronic inflammation (2.3 +/- 1.3%). These findings show that cervical lymph nodes of varying origin differ by virtue of their pattern of vascularity, with increased vascularity detectable after administration of a signal enhancer.

Topics: Carcinoma, Squamous Cell; Contrast Media; Diagnosis, Differential; Head and Neck Neoplasms; Humans; Inflammation; Lymph Nodes; Lymphatic Diseases; Lymphatic Metastasis; Lymphoma; Neck; Polysaccharides; Ultrasonography, Doppler, Color

The intravenous injection of an ultrasound contrast agent can enhance signals from blood flow. Broad toxicological and pharmaceutical studies in animals confirmed the safety and efficacy of an ultrasound contrast agent made of microparticles of galactose with stabilised microbubbles in watery suspension (SH U 508 A). In this paper 10 patients with different malignant orbital and ocular tumours have been evaluated with an echo colour Doppler machine before and after the injection of SH U 508 A. An enhancement of the Doppler signals in the lesions in different degrees has been detected. This echographic contrast agent seems to be very important not only in the evaluation of vascular lesions, but also in evaluating the effectiveness of radiotherapy in malignant tumours and could spread the echographic indications in several other ophthalmic fields.

Topics: Adult; Aged; Aged, 80 and over; Eye Neoplasms; Female; Humans; Lymphoma; Male; Melanoma; Middle Aged; Orbital Neoplasms; Polysaccharides; Ultrasonography, Doppler, Color