Diagnostic outcome of contrast enhanced Doppler sonography in determination of vascularity in reactively enlarged lymph nodes

Purpose: This prospective study was perform ed to investigate characteristi c sonomorphological features and vascularity of reactively enlarged lymph n odes. Method: We examined 40 patients with enlarged lymph nodes of the neck by Do ppler sonography before and after administration of an ultrasound signal-en hancing 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 a n echogenoic "hilus reflex" (3).The quantitative and qualitative criteria w ere compared to histological findings. Results: A total of 15 lymph nodes appeared homogeneous. A centrally locate d echogenoic line was found in 17 (42.5%) nodes and echogenoic "hilus refle x" in 8 (20%). These sonomorphological patterns correlate to hilus fibrosis in the histological specimen. In 32.5% (13) of the nodes the analysis of v ascularity was possible only after application of the galactose-based ultra sound signal enhancer. Quantitative analysis did not result in specific new aspects. Conclusions: Reactive lymph nodes show typical sonomorphological features. Administration of an ultrasound enhancer allows assessment of a characteris tic nodal vascualrity.