Ces radiol. 2010, 64(1):20-27

Contrast-enhanced ultrasound of peripheral lymph nodes - radiologic-pathologic correlationOriginal article

Radka Jakubcová¹, Mojmír Moulis², David Šálek³, Jakub Foukal¹

¹ Radiologická klinika LF MU a FN, Brno

² Ústav patologie LF MU a FN, Brno

³ Interní hematoonkologická klinika FN, Brno

Aim: On the basis of correlation of ultrasound and histological findings to determine changes in the structure of examined benign and malignant lymph nodes, that led to various types of enhancement in contrast-enhanced ultrasound examination.

Method: 78 patients with peripheral lymphadenopathy were examined from January 2008 to July 2009 (27 women and 51 men, age 22-86 years), total number of 82 lymph nodes were extirpated. All patients were examined with Philips iU22 ultrasound machine with 17MHz probe natively and with 9MHz probe after intravenous application of 1.5 ml sulphur hexafluoride contrast agent (SonoVue®, Bracco, Italy). According to postcontrast enhancement lymph nodes were divided into benign and malignant group. Lymph nodes were subsequently extirpated and examined histologically. Ultrasound and histological findings were correlated.

Results: The overall accuracy of the method was 92,7% for CEUS. In total 76 lymph nodes (92,7%) were correctly evaluated in terms of their benign or malignant changes. Five histologically benign lymph nodes (6,1%) were incorrectly identified as malignant ones. One malignant node was incorrectly classified as benign by CEUS. In most cases of malignant lymphadenopathy it was possible to distinguish between metastasis and lymphoproliferative disorder.

Conclusion: Various processes developing in the lymph node are also reflected in the macroscopic image of the node in contrast-enhanced ultrasound examination. Depending on the type of contrast agent distribution in the node, we can assess the maintenance or, on the contrary, disappearance of its normal structure in most cases, and thus to distinguish between benign and malignant process.

Keywords: sulphur hexafluoride, contrast-enhanced ultrasound, lymphadenopathy

Accepted: August 15, 2009; Published: March 1, 2010  Show citation