Ahuja A, Ying M
Department of Diagnostic Radiology & Organ Imaging, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Br J Oral Maxillofac Surg. 2000 Oct;38(5):451-9. doi: 10.1054/bjom.2000.0446.
Ultrasound examinations of the neck in 218 patients with confirmed cervical lymphadenopathy were reviewed. Lymph nodes were assessed for their size, shape, internal architecture, echogenicity, nodal border, posterior enhancement, and ancillary features (adjacent soft tissues oedema, and matting). The hilus is a linear, echogenic, non-shadowing structure containing nodal vessels, and is continuous with fat around the node. Coagulation necrosis is an ill-defined, rounded, non-shadowing echogenic area within a node. It is less echogenic than the hilus and is not continuous with the fat around the node. Calcification is a highly echogenic focus within the node, which may be dense or punctate echogenic foci. It is not continuous with the fat around the node. Dense intranodal calcification usually produces shadowing. However, fine punctate calcification may not have posterior shadowing though, if the transducer frequency is increased, it may show thin lines. Cystic necrosis is focal, often ill-defined echolucent area within the node. Echogenicity of lymph nodes is usually compared with the adjacent muscles, and is classified as hypoechogenicity, isoechogenicity, and hyperechogenicity. The nodal border is assessed for its sharpness. Posterior enhancement is when the structures posterior to the node look more echogenic than neighbouring areas. Oedema of soft tissues is an ill-defined, hypoechoic area around the node with loss of adjacent fascial planes. Nodes are considered matted when they are clumped or adherent to each other with no normal intervening soft tissue between them. Ultrasound features that help only in identifying abnormal nodes include size, shape, echogenic hilus, hypoechogenicity or isoechogenicity, echogeneity, coagulation necrosis, and a sharp nodal border. Ultrasound features that help to identify abnormal nodes as well as giving clues to the primary lesion include hyperechogenicity, intranodal calcification, intranodal cystic necrosis, ragged nodal border, posterior enhancement, adjacent soft tissue oedema, and matting.
回顾了218例确诊为颈部淋巴结病患者的颈部超声检查。对淋巴结的大小、形状、内部结构、回声性、淋巴结边界、后方增强以及附属特征（相邻软组织水肿和融合）进行评估。淋巴结门是一个线性、回声性、无阴影的结构，包含淋巴结血管，并与淋巴结周围的脂肪相连。凝固性坏死是淋巴结内一个边界不清、圆形、无阴影的回声区。其回声低于淋巴结门，且与淋巴结周围的脂肪不相连。钙化是淋巴结内的一个高回声灶，可为致密或点状回声灶。它与淋巴结周围的脂肪不相连。淋巴结内的致密钙化通常会产生声影。然而，细小的点状钙化可能没有后方声影，不过，如果增加探头频率，可能会显示出细线状。囊性坏死是淋巴结内的局灶性、通常边界不清的无回声区。淋巴结的回声性通常与相邻肌肉进行比较，并分为低回声、等回声和高回声。评估淋巴结边界的清晰度。后方增强是指淋巴结后方的结构看起来比相邻区域更具回声性。软组织水肿是淋巴结周围一个边界不清的低回声区，相邻筋膜平面消失。当淋巴结相互聚集或粘连，其间没有正常的间隔软组织时，就认为是融合的。仅有助于识别异常淋巴结的超声特征包括大小、形状、回声性淋巴结门、低回声或等回声、回声性、凝固性坏死和清晰的淋巴结边界。有助于识别异常淋巴结并为原发病变提供线索的超声特征包括高回声、淋巴结内钙化、淋巴结内囊性坏死、不规则的淋巴结边界、后方增强、相邻软组织水肿和融合。
