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Laryngorhinootologie 2022; 101(02): 156-175
DOI: 10.1055/a-1667-8675
Facharztwissen HNO

Sonografische Diagnostik im Kopf-Hals-Bereich – Teil 2: Transzervikale Sonografie

Sonographic diagnostics in the head and neck area, part 2 – transcervical sonography
Johannes Matthias Weimer‡
,
Maximilian Rink‡
,
Lukas Müller
,
Christoph Arens
,
Alessandro Bozzato
,
Julian Künzel
1   Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Regensburg
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Die transzervikale Sonografie ist aus der Diagnostik der Hals-Nasen-Ohren-Heilkunde nicht mehr wegzudenken. Darum sollte der Anwender bzw. die Anwenderin ein Grundverständnis der Ultraschallphysik und technischer Innovationen haben. In diesem Fortbildungsartikel spannen die Autoren den Bogen von der Einführung in die strukturierte Untersuchungstechnik bis hin zu einem klinischen Update zur Sonografie von Kopfspeicheldrüsen und Halslymphknoten.

Abstract

Transcervical sonography has become an integral part of the diagnostic spectrum of otorhinolaryngology, as evidenced by its firm inclusion in continuing education catalogs and guidelines. For these reasons, the user should be aware of a basic understanding of ultrasound physics and of technical innovations. A standardized examination scheme with structured reporting and documentation is an elementary prerequisite to meet the daily clinical challenges and to be able to answer specific questions. In this educational article, we span from an introduction to structured examination techniques to a clinical update on sonography of the cephalic glands and cervical lymph nodes.

Lernziel

Nach dem Studium des Absatzes sollte der Leser die Anforderungen einer strukturierten Ultraschallbefunderstellung kennen.

Lernziel

Nach dem Studium des Absatzes sollte der Leser die technischen Möglichkeiten jenseits der konventionellen B-Bild-Sonografie kennen.

Lernziel

Nach dem Studium des Absatzes sollte der Leser wesentliche Aspekte einer routinemäßigen Kopf- und Halssonografie verstanden haben.

Lernziel

Nach dem Studium des Absatzes sollte der Leser entzündliche und solide Veränderungen der Kopfspeicheldrüsen mittels Ultraschalls differenzieren können.

Lernziel

Nach der Lektüre dieses Kapitels kennt der Leser die wesentlichen klinischen Aspekte der sonografischen Diagnostik von Halslymphknotenpathologien.

Schlüsselwörter

Ultraschall - Kopf-Hals-Sonografie - Speicheldrüsen - Halslymphknoten - Bildgebung

Keywords

ultrasound - head-neck-sonography - salivary glands - cervical lymph nodes - imaging


Publication History

Article published online:
28 January 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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  • Literatur

  • 1 Heyduck A, Jecker P, Bozzato A. A german-wide inquiry about the significance of ultrasound in the head and neck area. Laryngo-Rhino-Otol 2018; 97: 392-397
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Bundesärztekammer. (Muster-)Weiterbildungsordnung 2018 in der Fassung vom 12./13.11.2020. Berlin: Bundesärztekammer; 2018
    PubMedSearch in Google Scholar
  • 3 Deutsche Röntgengesellschaft. S1-Leitlinie „Radiologische Diagnostik im Kopf-Hals-Bereich“, 2020. AWMF Register-Nr. 039–93. Accessed November 21, 2021 at: https://www.awmf.org/uploads/tx_szleitlinien/039–093l_S1_Radiologische-Diagnostik-im-Kopf-Hals-Bereich_2021–02.pdf
    PubMed
  • 4 Deutsche Gesellschaft für Ultraschall in der Medizin e.V. Kurscurriculum der Sektion Kopf-Hals. Berlin: Deutsche Gesellschaft für Ultraschall in der Medizin; 2015. Accessed November 21, 2021 at: https://www.degum.de/fileadmin/dokumente/sektionen/kopf-hals/KPF_2015__Kurscurriculum_2015–05–18.pdf
    PubMed
  • 5 Kunzel J, Bozzato A, Strieth S. Follow-up ultrasound of head and neck cancer. HNO 2017; 65: 939-952
    CrossrefPubMedSearch in Google Scholar
  • 6 Kunzel J, Strieth S, Wirth G. et al. Ultrasound in the re-staging of cervical metastases after chemoradiotherapy for head and neck cancer. Ultraschall Med 2018; 39: 659-666
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Bozzato A. Interpretation of ultrasound findings in otorhinolaryngology: skin, soft tissue of the neck, lymph nodes, and oncologic follow-up. HNO 2015; 63: 139-154
    CrossrefPubMedSearch in Google Scholar
  • 8 Vereinbarung von Qualitätssicherungsmaßnahmen nach § 135 Abs. 2 SGB V zur Ultraschalldiagnostik (Ultraschall-Vereinbarung) vom 31.10.2008; Fassung vom 01.10.2020. Accessed November 21, 2021 at: https://www.kbv.de/media/sp/Ultraschallvereinbarung.pdf
    PubMed
  • 9 Ernst BP, Katzer F, Kunzel J. et al. Impact of structured reporting on developing head and neck ultrasound skills. BMC Med Educ 2019; 19: 102
    CrossrefPubMedSearch in Google Scholar
  • 10 Ernst BP, Strieth S, Katzer F. et al. The use of structured reporting of head and neck ultrasound ensures time-efficiency and report quality during residency. Eur Arch Otorhinolaryngol 2020; 277: 269-276
    CrossrefPubMedSearch in Google Scholar
  • 11 Kunzel J, Bozzato A, Ernst BP. et al. Quality in the appraisal of head and neck sonography results in university hospitals-a random sample. HNO 2021; 69 (11) 907-912
    CrossrefPubMedSearch in Google Scholar
  • 12 Ernst BP, Strieth S, Kunzel J. et al. Evaluation of optimal education level to implement structured reporting into ultrasound training. Med Ultrason 2020; 22: 445-450
    CrossrefPubMedSearch in Google Scholar
  • 13 Kloth C, Kratzer W, Schmidberger J. et al. Ultrasound 2020 – diagnostics & therapy: on the way to multimodal ultrasound: contrast-enhanced ultrasound (CEUS), microvascular Doppler techniques, fusion imaging, sonoelastography, interventional sonography. Röfo 2021; 193: 23-32
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Jung EM, Clevert DA. Contrast-enhanced ultrasound (CEUS) and image fusion for procedures of liver interventions. Radiologe 2018; 58: 538-544
    CrossrefPubMedSearch in Google Scholar
  • 15 Lee MW. Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention. Ultrasonography 2014; 33: 227-239
    CrossrefPubMedSearch in Google Scholar
  • 16 Goeral K, Hojreh A, Kasprian G. et al. Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI). Eur Radiol 2019; 29: 2127-2136
    CrossrefPubMedSearch in Google Scholar
  • 17 Sim JK, Lee JY, Hong HS. Differentiation between malignant and benign lymph nodes: role of superb microvascular imaging in the evaluation of cervical lymph nodes. J Ultrasound Med 2019; 38: 3025-3036
    CrossrefPubMedSearch in Google Scholar
  • 18 Strobel D, Seitz K, Blank W. et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions – diagnostic accuracy in clinical practice (DEGUM multicenter trial). Ultraschall Med 2008; 29: 499-505
    Thieme ConnectPubMedSearch in Google Scholar
  • 19 Trimboli P, Castellana M, Virili C. et al. Performance of contrast-enhanced ultrasound (CEUS) in assessing thyroid nodules: a systematic review and meta-analysis using histological standard of reference. Radiol Med 2020; 125: 406-415
    CrossrefPubMedSearch in Google Scholar
  • 20 Dudau C, Hameed S, Gibson D. et al. Can contrast-enhanced ultrasound distinguish malignant from reactive lymph nodes in patients with head and neck cancers?. Ultrasound Med Biol 2014; 40: 747-754
    CrossrefPubMedSearch in Google Scholar
  • 21 Yu M, Liu Q, Song HP. et al. Clinical application of contrast-enhanced ultrasonography in diagnosis of superficial lymphadenopathy. J Ultrasound Med 2010; 29: 735-740
    CrossrefPubMedSearch in Google Scholar
  • 22 Klintworth N, Mantsopoulos K, Zenk J. et al. Sonoelastography of parotid gland tumours: initial experience and identification of characteristic patterns. Eur Radiol 2012; 22: 947-956
    CrossrefPubMedSearch in Google Scholar
  • 23 Hong Y, Liu X, Li Z. et al. Real-time ultrasound elastography in the differential diagnosis of benign and malignant thyroid nodules. J Ultrasound Med 2009; 28: 861-867
    CrossrefPubMedSearch in Google Scholar
  • 24 Lee L, DeCara JM. Point-of-care ultrasound. Curr Cardiol Rep 2020; 22: 149
    CrossrefPubMedSearch in Google Scholar
  • 25 You-Ten KE, Siddiqui N, Teoh WH. et al. Point-of-care ultrasound (POCUS) of the upper airway. Can J Anaesth 2018; 65: 473-484
    CrossrefPubMedSearch in Google Scholar
  • 26 Angerer F, Zenk J, Iro H. et al. Use of a portable ultrasound system in the perisurgical assessment of head and neck patients. HNO 2013; 61: 866-871
    CrossrefPubMedSearch in Google Scholar
  • 27 AIUM-ACR-SPR-SRU Practice parameter for the performance and interpretation of a diagnostic ultrasound examination of the extracranial head and neck. J Ultrasound Med 2018; (37) E6-E12
    CrossrefPubMedSearch in Google Scholar
  • 28 AIUM practice guideline for the performance of ultrasound examinations of the head and neck. J Ultrasound Med 2014; 33: 366-382
    CrossrefPubMedSearch in Google Scholar
  • 29 Adeyemo W, Ogunlewe M, Ladeinde A. Ultrasound as a diagnostic aid in head and neck lesions. Niger Postgrad Med J 2006; 13: 147-152
    CrossrefPubMedSearch in Google Scholar
  • 30 Klem C. Head and neck anatomy and ultrasound correlation. Otolaryngol Clin Nort Am 2010; 43: 1161-1169
    CrossrefPubMedSearch in Google Scholar
  • 31 Wu VWC, Ying MT, Kwong DL. et al. A longitudinal study on parotid and submandibular gland changes assessed by magnetic resonance imaging and ultrasonography in post-radiotherapy nasopharyngeal cancer patients. BJR open 2020; 2: 20200003
    CrossrefPubMedSearch in Google Scholar
  • 32 Saied F, Włodkowska-Korytkowska M, Maślińska M. et al. The usefulness of ultrasound in the diagnostics of Sjögrenʼs syndrome. J Ultrasonogr 2013; 13: 202-211
    CrossrefPubMedSearch in Google Scholar
  • 33 Manfrè V, Giovannini I, Zandonella Callegher S. et al. Ultrasound and bioptic investigation of patients with primary Sjögrenʼs syndrome. J Clin Med 2021; 10 (06) 1171
    CrossrefPubMedSearch in Google Scholar
  • 34 Mansour N, Hofauer B, Knopf A. Ultrasound elastography in diffuse and focal parotid gland lesions. ORL J Otorhinolaryngol Relat Spec 2017; 79: 54-64
    CrossrefPubMedSearch in Google Scholar
  • 35 David E, Cantisani V, de Vincentiis M. et al. Contrast-enhanced ultrasound in the evaluation of parotid gland lesions: an update of the literature. Ultrasound (Leeds, England) 2016; 24: 104-110
    CrossrefPubMedSearch in Google Scholar
  • 36 Martino M, Fodor D, Fresilli D. et al. Narrative review of multiparametric ultrasound in parotid gland evaluation. Gland Surg 2020; 9: 2295-2311
    CrossrefPubMedSearch in Google Scholar
  • 37 Psychogios G, Bohr C, Constantinidis J. et al. Review of surgical techniques and guide for decision making in the treatment of benign parotid tumors. Eur Arch Otorhinolaryngol 2021; 278: 15-29
    CrossrefPubMedSearch in Google Scholar
  • 38 Tauro F, Cianfrone F, Ralli M. et al. Retrospective study of salivary gland tumor cases in a large italian public hospital and review of the literature. Clin Terap 2021; 172: 168-171
    CrossrefPubMedSearch in Google Scholar
  • 39 Hiyama T, Kuno H, Sekiya K. et al. Imaging of malignant minor salivary gland tumors of the head and neck. RadioGraphics 2021; 41: 175-191
    CrossrefPubMedSearch in Google Scholar
  • 40 Zhao L, Mu J, Mao Y. et al. Diagnostic value of superb microvascular imaging in parotid tumors. Med Sci Monit 2020; 26: e921813
    CrossrefPubMedSearch in Google Scholar
  • 41 Berner F, Koch M, Müller SK. et al. Investigation of sonographic criteria for reliable identification of T1-T2 low-grade malignant tumors of the parotid gland. Ultrasound Med Biol 2021; 47: 471-477
    CrossrefPubMedSearch in Google Scholar
  • 42 Mansour N, Stock KF, Chaker A. et al. Evaluation of parotid gland lesions with standard ultrasound, color duplex sonography, sonoelastography, and acoustic radiation force impulse imaging – a pilot study. Ultraschall Med 2012; 33: 283-288
    Thieme ConnectPubMedSearch in Google Scholar
  • 43 Jiang LP. Characteristics of pleomorphic adenomas, adenolymphomas, and malignant tumors of the salivary glands on color Doppler ultrasonography and contrast enhanced ultrasonography. Eur Rev Med Pharmacol Sci 2020; 24: 11509-11517
    CrossrefPubMedSearch in Google Scholar
  • 44 Furukawa MK, Furukawa M. Diagnosis of lymph node metastases of head and neck cancer and evaluation of effects of chemoradiotherapy using ultrasonography. Int J Clin Oncol 2010; 15: 23-32
    CrossrefPubMedSearch in Google Scholar
  • 45 Steinkamp HJ, Cornehl M, Hosten N. et al. Cervical lymphadenopathy: ratio of long- to short-axis diameter as a predictor of malignancy. BJR 1995; 68: 266-270
    CrossrefPubMedSearch in Google Scholar
  • 46 Alam F, Naito K, Horiguchi J. et al. Accuracy of sonographic elastography in the differential diagnosis of enlarged cervical lymph nodes: comparison with conventional B-mode sonography. AJR Am J Roentgenol 2008; 191: 604-610
    CrossrefPubMedSearch in Google Scholar
  • 47 Ying M, Bhatia K, Lee YP. et al. Review of ultrasonography of malignant neck nodes: greyscale, Doppler, contrast enhancement and elastography. Cancer Imaging 2013; 13: 658-669
    CrossrefPubMedSearch in Google Scholar
  • 48 Bruneton JN, Roux P, Caramella E. et al. Ear, nose, and throat cancer: ultrasound diagnosis of metastasis to cervical lymph nodes. Radiology 1984; 152: 771-773
    CrossrefPubMedSearch in Google Scholar
  • 49 Tschammler A, Ott G, Schang T. et al. Lymphadenopathy: differentiation of benign from malignant disease – color Doppler US assessment of intranodal angioarchitecture. Radiology 1998; 208: 117-123
    CrossrefPubMedSearch in Google Scholar
  • 50 Na DG, Lim HK, Byun HS. et al. Differential diagnosis of cervical lymphadenopathy: usefulness of color Doppler sonography. Am J Roentgenol 1997; 168: 1311-1316
    CrossrefPubMedSearch in Google Scholar
  • 51 Wu CH, Chang YL, Hsu WC. et al. Usefulness of Doppler spectral analysis and power Doppler sonography in the differentiation of cervical lymphadenopathies. Am J Roentgenol 1998; 171: 503-509
    CrossrefPubMedSearch in Google Scholar
  • 52 Poanta L, Serban O, Pascu I. et al. The place of CEUS in distinguishing benign from malignant cervical lymph nodes: a prospective study. Med Ultrason 2014; 16: 7-14
    CrossrefPubMedSearch in Google Scholar
  • 53 Slaisova R, Benda K, Jarkovsky J. et al. Contrast-enhanced ultrasonography compared to gray-scale and power Doppler in the diagnosis of peripheral lymphadenopathy. Eur J Radiol 2013; 82: 693-698
    CrossrefPubMedSearch in Google Scholar
  • 54 Mei M, Ye L, Quan J. et al. Contrast-enhanced ultrasound for the differential diagnosis between benign and metastatic superficial lymph nodes: a meta-analysis. CMAR 2018; 10: 4987-4997
    CrossrefPubMedSearch in Google Scholar
  • 55 Choi YJ, Lee JH, Baek JH. Ultrasound elastography for evaluation of cervical lymph nodes. Ultrasonography 2015; 34: 157-164
    CrossrefPubMedSearch in Google Scholar
  • 56 Mantsopoulos K, Klintworth N, Iro H. et al. Applicability of shear wave elastography of the major salivary glands: values in healthy patients and effects of gender, smoking and pre-compression. Ultrasound Med Biol 2015; 41: 2310-2318
    CrossrefPubMedSearch in Google Scholar
  • 57 Desmots F, Fakhry N, Mancini J. et al. Shear wave elastography in head and neck lymph node assessment: image quality and diagnostic impact compared with B-mode and Doppler ultrasonography. Ultrasound Med Biol 2016; 42: 387-398
    CrossrefPubMedSearch in Google Scholar
  • 58 Cheng KL, Choi YJ, Shim WH. et al. Virtual touch tissue imaging quantification shear wave elastography: prospective assessment of cervical lymph nodes. Ultrasound Med Biol 2016; 42: 378-386
    CrossrefPubMedSearch in Google Scholar
  • 59 Zhao Y, Xi J, Zhao B. et al. Preliminary evaluation of virtual touch tissue imaging quantification for differential diagnosis of metastatic and nonmetastatic cervical lymph nodes. J Ultrasound Med 2017; 36: 557-563
    CrossrefPubMedSearch in Google Scholar
  • 60 Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH). Leitlinie „Lymphknotenvergrößerung“, 2020. AWMF Register-Nr. 025_020. Accessed November 21, 2021 at: https://www.awmf.org/leitlinien/detail/ll/025–020.html
    PubMed