Differential diagnosis of small round cervical lymph nodes: comparison of power Doppler US with contrast-enhanced CT and pathologic results
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Updated: Jul 31, 2026
High-frequency Ultrasound Imaging of Mouse Cervical Lymph Nodes
Published on: July 25, 2015
T Sakaguchi1, Y Yamashita, K Katahira
1Department of Radiology, Kumamoto University School of Medicine, Honjo, Japan.
Purpose:
The purpose of this study was to differentiate reactive small round lymph nodes (SRLNs) from metastases by power Doppler ultrasonography (PD-US) and contrast-enhanced CT (CE-CT).
Materials And Methods:
Both PD-US and CE-CT were performed in 99 cervical lymph nodes (LNs) with a maximum diameter of 1.5 cm or smaller and maximum longitudinal/transverse ratio of 1.5 or smaller in 76 patients with head and neck cancer. At pathologic examinations, 45 were reactive and 54 were metastatic LNs. The vascular patterns on PD-US were classified as hilar, avascular, peripheral, and miscellaneous vascular patterns. The enhancement patterns on CE-CT were classified as homogeneous, heterogeneous, and ring enhancement.
Results:
On PD-US, the hilar pattern was more frequently associated with benignancy (91%) and the peripheral, miscellaneous vascular pattern with malignancy (91%). The avascular pattern included both benign (58%) and malignant (42%) LNs. On PD-US, accuracy was 85%. On CE-CT, ring enhancement showed metastasis (100%), and these LNs showed avascular or peripheral patterns on PD-US. On CE-CT, accuracy was 77%. When information on CE-CT results was added to PD-US results, the accuracy rate increased significantly, to 94% (p=0.01).
Conclusion:
Vascular patterns evaluated with PD-US and enhancement patterns on CE-CT can characterize SRLNs. For an avascular pattern on PD-US, information on CE-CT results can significantly increase the accuracy of characterization.
