Conventional ultrasound for lymph node evaluation, update 2013

Abstract

Conventional ultrasound is regarded as the first method of choice to evaluate lymph node disease due to its high resolution. The combination of various features obtained from the patients history including age, acute or chronic onset, symptoms, and a knowledge of underlying systemic diseases as well as imaging criteria, most importantly B-mode (gray-scale) and colour Doppler imaging (CDI) are the basis for the differential diagnosis of lymphadenopathy. New ultrasound techniques such as elastography and contrast-enhanced ultrasound may provide further information. In addition, ultrasound evaluation of lymph nodes is an essential adjunct to the clinical investigation in staging of malignant neoplasia and lymphoma. In this paper the current literature is reviewed regarding conventional B-mode and Doppler ultrasound for the evaluation of lymphadenopathy. The ultrasound criteria for the differential diagnosis of enlarged and structurally altered lymph nodes are summarized and also limitations are described.

Zusammenfassung

Sonografische Techniken sind die Methode der Wahl zur bildgebenden Abklärung der Lymphadenopathie. Die sonografische Lymphknotendiagnostik schließt B-Bild- und Farbdopplerkriterien genauso ein wie das Wissen um die Patientenanamnese, das Alter, den akuten oder chronischen Verlauf der Erkrankung sowie Erkenntnisse über Symptome und die Begleiterkrankungen. Elastografische und kontrastverstärkte Methoden können weitere Informationen beisteuern. Der Ultraschall hat sich für die Diagnosestellung und auch zum Staging von malignen Erkrankungen einschließlich von Lymphomen etabliert. In dem vorliegenden Übersichtsartikel werden die klinischen Aspekte der sonografischen Lymphknotendiagnostik diskutiert. Dabei wird sowohl eine Übersicht über konventionelle B-Bild- und Dopplerkriterien gegeben als auch die Differentialdiagnose von vergrößerten Lymphknoten erörtert. Die Limitationen der Lymphknotendiagnostik werden aufgezeigt.

Schlüsselwörter

Lymphknoten - Sonografie - Endosonografie - Lymphknotenmetastasen - Lymphom

Key words

lymph nodes - ultrasound - endoscopic ultrasound - lymph node metastasis - lymphoma

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