[Diagnostic value of signal-enhanced color Doppler sonography in reactively enlarged lymph nodes]

This prospective study was performed to investigate characteristic sonomorphological features and vascularity of reactively enlarged lymph nodes.

We examined 40 patients with enlarged lymph nodes of the neck by Doppler sonography before and after administration of an ultrasound signal-enhancing agent. Peak flow velocity, pulsatility- and resistant indices were assessed. Lymph nodes were sonomorphologically classified into three groups: homogeneous parenchyma (1), a centrally located echogenoic line (2) and an echogenoic "hilus reflex" (3). The quantitative and qualitative criteria were compared to histological findings.

A total of 15 lymph nodes appeared homogeneous. A centrally located echogenoic line was found in 17 (42.5%) nodes and echogenoic "hilus reflex" in 8 (20%). These sonomorphological patterns correlate to hilus fibrosis in the histological specimen. In 32.5% (13) of the nodes the analysis of vascularity was possible only after application of the galactose-based ultrasound signal enhancer. Quantitative analysis did not result in specific new aspects.

Reactive lymph nodes show typical sonomorphological features. Administration of an ultrasound enhancer allows assessment of a characteristic nodal vascualrity.