Results: The most common useful sonographic features to identifydifferent types of cervical lymph nodes were S:L ratio, nodal margins,hilar echogenicity, vascular pattern, matting, soft tissue edema, echo-genicity, intranodal necrosis, displaced hilar vascularity, eccentric cor-tical hypertrophy and posterior enhancement. Vascularity was the mostaccurate parameter (86%) when used in isolation and when combinedparameters were used ultrasound had the highest accuracy of 97% indiagnosing benign or malignant cervical lymphadenopathy.Conclusions: High resolution ultrasound has a high degree of accuracyin differentiating benign and malignant cervical lymphadenopathy andassists in differentiating various causes of lymphadenopathy.

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Color Doppler ultrasound in the evaluation of salivary glandtumorChen H-C, Chiu N-C, Tiu C-M, Chiou H-J, Chiou S-Y, Wang H-K,Li W-Y, Chang C-Y, Dept. of Radiology, Veterans General Hospital,Taipei, Taiwan; Dept. of Pathology, Veterans General Hospital,Taipei, Taiwan

Objectives: Ultrasound (US) is a highly effective non-invasive imag-ing tool to detect salivary gland tumors. The purpose of this study is toevaluate whether color Doppler US (CDU), in combination of gray-scale imaging, is able to distinguish the nature of salivary gland tumor.Methods: Thirty-three patients with 34 salivary gland lesions wereprospectively evaluated with high resolution CDU. The distributionand grading of color flow signals were documented. Spectral Dopplerwaveforms from the areas with relatively prominent CFS were alsoobtained for analysis. The gray-scale morphology (e.g., shape, margin,boundary, echogenicity) and CDU finding (e.g., distribution of CFS)were correlated with the histopathological studies.Results: There were 11 mixed tumors, 16 Warthin’s tumors and 6malignant tumors. All tumors arose from parotid or submandibularglands. Almost all tumors (92%) were well circumscribed. Predomi-nant cystic component is the major difference between mixed tumorand Warthin’s tumor. The predominant peripheral distribution of CFS(basket pattern) in mixed tumor also help in differentiating this twoentities. Malignant tumors demonstrated a higher grade of tumor vas-cularity (profuse or intermediate, 83%), while benign tumors showedminimal to intermediate vascularity (74%). Both Warthin’s tumors andlymphomas showed central feeling arteries which could not be seen inmixed tumors.Conclusions: CDU can be used to predict the nature of salivary glandtumors. The distribulation of intratumoral CFS and the gray-scalemorphology may help to differentiate mixed tumor from Warthin’stumor.

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Percutaneous therapy for head and neck cystic massesShiels WE, Children’s Hospital, Columbus, Ohio, United States ofAmerica

Objectives: To report successful sonographically guided catheter ac-cess and percutaneous interventional radiological therapy of variouscystic masses in the head and neck, to include intraorbital masses.Methods: Thirty nine patients (ages 3 days to 57 y) were treated forhead and neck lymphatic malformations, dermoid cysts, branchial cleftcysts, simple ranulas, and plunging ranulas. Coaxial catheter accesswas performed with 14G angiocatheter through which 5F pigtail cath-eter was placed. Cystic masses were primarily treated with dual drugablation therapy consisting of sequential sodium tetradecyl sulfate andethanol. Ranulas were definitely treated with regional ethanol ablationof the respective salivary gland.

Results: Nineteen of twenty macrocystic lymphatic malformationswere successfully ablated in a single treatment. Four of five dermoidcysts were ablated with a single treatment, one requiring a secondtreatment; 100% of branchial cleft cysts were ablated. All nine ranulaswere successfully treated without recurrence. Infection was the onlycomplication occurring in only one patient. No complications of blind-ness or extraocular muscle damage.Conclusions: Cystic masses of the head and neck can be successfullytreated with precise sonographically guided access and catheter baseddual drug ablation. Catheter drainage and regional gland ablation areeffective for treatment of cervical ranulas.

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Transfacial ultrasonographic evaluation for tongue cancerLee JY, Lee K, Lee Y, Bae SH, Hallym Sacred Heart Hospital,Korea

Objectives: Previous studies have presented intraoral ultrasonographyfor evaluation and follow up of tongue cancer. We present our expe-rience of transfacial ultrasonographic evaluations for tongue cancer,and assess the feasibility of staging work up in a series of patients.Methods: From July 2003 to June 2005, we performed transfacialultrasonography for histologically proven tongue cancer in 8 patients(male � 6, female � 2; mean age, 43.9 years; range from 27 to 64years). Transfacial sonography was performed using C5-8 or L12-5linear transducer. Visualization of the tongue cancer was done with theapplication of probe in the cheek at the side of tongue lesion. Preop-erative and specimen sonograms were compared with pathologic find-ings including postoperative T staging.Results: Preoperative sonograms showed lobulated, heterogeneous lowechoic pattern and some microlobulation compared with normaltongue. All lesions have not involved midline of tongue. All patientsreceived partial glossectomy. Preoperative and specimen sonographicresults of T staging revealed excellent correlation (100 %) with post-operative T staging.Conclusions: In evaluation for tongue cancer, transfacial ultrasonog-raphy is feasible, and offering some advantage over currently usedstaging work up modality.

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Metastases of the skull: The value of ultrasoundMende UH, Welzel T, Mende M, Moldenhauer J, Dinkel J,University Hospital Heidelberg, Germany; University of Karlsruhe,Dept. of Informatics, Germany

Objectives: To assess the value of ultrasound for the diagnosis, ther-apy-planning and follow-up of skull metastases by analysis of sono-graphically evaluated data and comparison to standard CT/MRI.Methods: Over 130 skull metastases underwent up to four sonographicexaminations, in part with complementary color-/power Doppler and3D-ultrasound (�power Doppler). A retrospective analysis was doneon the dimensions, volume, echogeneity and vessel density of bone andsoft tissue tumors dependent on the primary, follow-up controls underradiotherapy (50) and correlation to CT/MRI (82).Results: Considering the bone defects only underestimates the meta-static processes significantly (p � 0.0001) due to the accompanyingsoft tissue processes, especially in case of tumors of the lung or thekidney. If the lesions do not considerably exceed the dimensions of thetransducer, dimensions and volume correlate well to those of CT andMRI (correlation coefficients 0.88 to 0.95). Significant changes of sizeand structure (echogeneity, vessel density) indicate response to radio-therapy and recalcification early and reliably.Conclusions: Easily available ultrasound (with power Doppler and 3D)can improve the diagnosis, therapy-planning and follow-up of skull

Abstracts P141