Journal of Korean Society of Medical Ultrasound 2001;20(3): 213-219.
Ultrasonographic Diagnosis of Cervical Tuberculous Lymphadenitis.
Ho Seung Lee, Yong Seon Pyeun, Sang Wook Lee, Myung Ho Rho
Department of Radiology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine
  Published online: September 1, 2001.
ABSTRACT
PURPOSE: To evaluate findings of gray-scale and color Doppler sonography in cervical tuberculous lymphadenitis (CTA). MATERIALS AND METHODS: We retrospectively reviewed sonograms of tuberculous lymph nodes in eighty one patients confirmed by ultrasound-guided cutting-needle biopsy. We evaluated number, laterality, size and shape, distribution, echogenic hilus, chogeneity, echogenicity, nodal border, surrounding soft tissue thickening, matting, calcification on gray-scale sonograms. On color images, we analyzed the patterns of vascularity in thirty two nodes. RESULTS: Multiple (79%) and unilateral (90%) lymph nodes enlargement were seen. The largest diameter was from 10 mm to 33 mm (mean: 19 mm). Most commonly involving area was posterior triangle (83%), followed by involvement of internal jugular chain (49%) and supraclavicular fossa (36%). In only 5 of 81 (6%) patient, the echogenic hilum was seen. The omogeneous (83%), low echogenic lymph nodes (86%) with well defined border(82%) was characteristic findings. In 11 of 14 heterogeneous echogeneity and 9 of 15 ill defined or irregular border of lymph nodes, abscess formation was proven by aspiration. On color Doppler sonogram, avascular (28%) and hilar vascular (9%) lymph nodes were seen. Whereas little (31%) and some peripheral vascularity (13%) and mixed patterns (19%) were noted in high percentage. CONCLUSION: The characteristic sonographic findings of CTA were multiple, round or oval, homogeneous, quiet lower echoic, well defined, non-matting lymph nodes at the posterior cervical triangle or internal jugular chain or supraclavicular fosssa with avascular or little vascularity. In cold abscesses, an inhomogeneous echotexture with irregular or ill defined border were characteristic findings.
Keywords: Tuberculosis; Lymphatic system, US; Neck, US
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