Purpose: Cervical lymphadenopathy is common in children. Ultrasonography is widely considered to be a useful method in the evaluation of the lymph nodes in children, but there is no previous report about the sonographic features and distribution of normal cervical nodes in children. The purpose of the study was to evaluate elastographic, power Doppler and B-mode ultrasound criteria for normal neck lymph nodes in children.
Methods: Fifty two healthy children had sonographic examination of the cervical lymph nodes. Lymph nodes were evaluated for their number, site, size, shape, echogenicity, echogenic hilus, vascular and elastographic patterns. The elasticity classification was referred to the scale proposed by Furukawa.
Results: A total of 929 lymph nodes were found in the 52 children. The mean number of nodes was 18 (range, 10-30).90,9% of the nodes has been found in three regions of the neck: upper cervical, posterior triangle and submandibular. More than 90% of the nodes showed oval shape (S/L≤0,5). Echogenic hilus was observed in 99,14% of nodes. Almost all of the lymph nodes were normoechoic in relation to the muscles of the neck and showed hilar vascularity. Most of the lymph nodes in the elastographic evaluation were rated as patterns ES1 and ES2 (95,5%). The mean muscle-to-lymph strain ratio (strain index) was 1,1.
Conclusions: The study provides important informations about sonographic and elastographic features of normal cervical lymph nodes in children.
