their affected gums. The cysts, abscesses and masses diagnosed anddifferentiated.Results: We got 3 (3.75%) solid masses, 22 (27.5%) infected gumswith or without abscess formation and 13 (16.25) cases of differenttypes of cysts. The remaining 42 had other dental pathology of pain orswelling. These 13 cases of cysts included three (23%) periapical cysts,two (15%) residual cyst, one (7.6%) dentigerous cyst, one (7.6%)eruption cyst, one (7.6%)paradental cyst, one (7.6%) odontogenickeratocyst, one (7.6%) gingival cyst and two (15%) pseudocysts.Conclusions: (1) Ultrasound is a good modality to diagnose differenttypes of mandibular cysts. (2) Ultrasound can help us in differentialdiagnosis of different types of cysts of jaw.

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Invasion of carotid artery by malignant tumors: SonographicdetectionChammas MC, Caiado AM, Pinho M, Simoes C, Marcelino A, SaitoO, Tavares M, Cerri G, Radiology Institute, University of Sao PauloMedical School, Sao Paulo, SP, Brazil

Objectives: To establish the value of sonographic criteria in detectinginvasion of carotid artery by malignant neoplasms.Methods: During a 3-year period, we examined 32 patients withproved cancer of head and neck. All patients were clinically suspectedof invasion; with computed tomography scanning inconclusive. Sixpatients have received radiation therapy previously. Sonography wasperformed with a 7–11 MHz transducer. The criteria for carotid inva-sion were loss of hyperechoic interface of the carotid wall tumorfixation, encasement and narrowing and deformity of the lumen.Results: Twenty patients underwent surgery, with pathologic correla-tion. Fourteen examinations were true-negative, three were true-posi-tive, none was falsely negative and three were falsely positive. Sensi-tivity was 100%. Specificity was 82.4%. Positive predictive value was50%. Negative predictive value was 100%. Accuracy was 85%.Conclusions: High resolution ultrasound showed a good accuracy indetecting malignant invasion of the carotid artery. Loss of hyperechoicinterface of the carotid wall, tumor fixation in the vessel wall andnarrowing and deformity of the lumen were the best criteria, when usedtogether. All falsely positive studies were associated with loss ofhyperechoic interface of the carotid wall, used as a single criterion.Dynamic maneuvers were very helpful to exclude infiltration.

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Clinical evaluation of ultrasonography for cervical lymph nodesmetastasis of nasopharyngeal carcinomaXu D, Qian C-W, Jiang F, Zhejiang Cancer Hospital, China

Objectives: To explore the clinical evaluation of ultrasonography forcervical lymph nodes metastasis of nasopharyngeal carcinoma (NPC), andto clarify whether ultrasonography is useful in the clinical-staging of NPC.Methods: Fifty-nine patients of incipient nasopharyngeal carcinomawere given detail examination in cervical lymph nodes with ultrasonog-raphy before radiotherapy, and 121 lymph nodes were performed fineneedle aspiration cytology(FNAC).Results: Of the 121 cervical lymph nodes, 83 were metastasis (68.6%),and most were in the superior group fields (33.7) and the posteriorcervical group fields (51.8%). Almost all of them were lower-echo andnoncalcification, and they had the following circumstance: rounded(79.5%), boundary (91.6%), envelope infringed (54.2%); 95.2 percentof them could not display the lymph node’s portal with high echo; fewof them had putrescence (7.2%) and showed the distal acoustic en-hancement (12.0%); many of them had abundant blood flowing signal(69.8%). The average PSV (peak systolic velocity) and RI (resistanceindex) was 27.5cm/s and 0.55, respectively.

Conclusions: Ultrasonography was accurate in measuring lymph nodes of theneck of nasopharyngeal carcinoma, it could be some valuable to the diagnosis,the clinical staging and guiding treatment in nasopharyngeal carcinoma.

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Unusual nodal disease in head and neck: Expand horizons ofcervical lymphadenopathyKim BJ, Suh S-I, Seol HY, Lee YH, Kim TK, Lee NJ, Kim JH, KimIS, Guro Hospital, Korea University College of Medicine, Korea;Anam Hospital, Korea University College of Medicine, Korea;Ansan Hospital, Korea University College of Medicine, Korea;Pathology, Guro Hospital, Korea University College of Medicine,Korea

The purpose of this essay is to demonstrate the sonographic features ofunusual cervical lymphadenopathy that was pathologically confirmedby gun-biopsy. A retrospective review of the grey-scale and powerDoppler sonographic imaging findings of the cervical lymph nodes ormasses in patients of Kikuchi’s disease, Kimura’s disease, Lupus-associated necrotizing lymphadenitis, erythema induratum, cryptococ-coma, schwannoma, Langerhans cell histiocytosis, amyloidosis andmalignant melanoma was performed. The lesions were pathologicallyconfirmed by 16G or 18G gun-biopsy (automatic cutting needle). Ongrey-scale ultrasound (US), lymph nodes were assessed by their size,shape, echogenicity and internal architecture. The vascular pattern ofthe lymph nodes was assessed with power Doppler sonography. Theradiologists and clinicians always keep in mind that possibility ofexistence of unusual cervical lymphadenopathy and should be familiarwith imaging findings and clinical features of them.

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Comparison of US, CT, and PET for evaluation ofsupraclavicular node in lung cancer: Correlation with results ofneedle aspiration biopsyHam S-Y, Oh Y-W, Lee Y, Kim J, In KH, Anam Hospital, KoreaUniversity, Korea

Objectives: To assess the diagnostic accuracy of the metastatic supra-clavicular node in lung cancer staging, correlation with CT, PET andUS guided aspiration biopsy results and comparison for the sensitivi-ties.Methods: We prospectively evaluated total 43 patients (33 men and 10women; mean age, 62.8 y) of lung cancer, underwent CT, PET and US.Total 13 patients (14 nodes) were performed fine-needle aspirationcytologic analysis. The diagnostic criterion is over 5 mm. Aspirationresults were used as a standard of reference. We analyzed the sensi-tivities of the imaging modalities, correlated with the fine needleaspiration cytology results.Results: Sensitivities and specificities of each imaging modality wereCT (0.89; 8/9), PET (1.0; 9/9) and US (1.0; 9/9); CT (0.8; 4/5) PET(1.0; 5/5) and US (0.0 0/5). False positivity was higher in US (0.8; 4/5nodes) than CT (0.2; 1/5), PET (0; 0/5). The positive results ofmetastasis were revealed in 9/14 nodes (64.2 %) by US guided aspi-ration. The mean diameters of the metastatic/reactive node were 12.7/7.1 mm.Conclusions: Supraclavicular node metastases proved by cytologywere 10/43 patients (23.3%). PET was superior to other modalities insensitivities and specificities. So, US guided aspiration and PET mighthave complimentary roles in the preoperative staging of lung cancer forsupraclavicular node metastasis.

Abstracts P243