Sonographic evaluation of jugulodigastric and juguloomohyoid lymph nodes

The jugulodigastric (JD) and juguloomohyoid (JO) lymph nodes are levels II and III cervical lymph nodes corresponding to the upper and middle internal jugular chains, respectively. The aim of this study is to delineate the sonographic properties of these two nodes, which are commonly encountered in routine neck sonography, in subjects with normal neck ultrasound findings. Atypical findings can make it difficult to differentiate benign from malignant lymph nodes. The JD and JO lymph nodes of 126 subjects were examined by ultrasonography, and size, shape, presence of echogenic hilus and Doppler activity were recorded. Among the lymph nodes examined, 31.6% were not elliptical. Proportionally more of the JO than the JD nodes were round; there was a significant difference in roundness index between them (P < 0.05). An echogenic hilus was demonstrated in 223 of the 252 JD nodes and in 161 of the 252 JO nodes. Significantly more of the lymph nodes with roundness index <2 lacked a visible echogenic hilus. There was a positive correlation between the visibility of an echogenic hilus and Doppler activity. Normal jugulodigastric and juguloomohyoid lymph nodes are relatively prominent in the upper and middle jugular chains, respectively. Awareness of variations in the sonographic appearance of these nodes could preclude unnecessary procedures. Clin. Anat. 29:943-948, 2016. © 2016 Wiley Periodicals, Inc.