Ultrasound evaluation of neck lymph nodes

Michael Ying PhD; Anil Ahuja FRCR; Fiona Brook PhD; *KT Wong FRCR Department of Optometry and Radiography, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China Department of Diagnostic Radiology & Organ Imaging, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China

ABSTRACT
Ultrasound is a useful imaging modality in the assessment of cervical lymph nodes. Grey scale sonography helps to evaluate the morphology of cervical nodes, whereas power Doppler sonography can be used to assess the vasculature of lymph nodes. The grey scale sonographic features that help distinguish the various causes of cervical lymphadenopathy include their size, shape, internal architecture, and distribution; the presence of intranodal necrosis, an echogenic hilus or calcification. The presence of adjacent soft tissue edema and matting of nodes are useful features to identify tuberculous lymphadenitis. In power Doppler sonography, vascular pattern of the lymph nodes is more useful than vascular resistance in differentiating benign from malignant cervical nodes.A good understanding of the normal lymph node anatomy, scanning equipment required and the scanning technique is essential before pathology assessment should be commenced.
This article reviews these topics to provide an overview for sonography of cervical lymphadenopathy.

Keywords: Ultrasound, grey scale, Doppler, cervical lymph nodes, normal, abnormal