頸部リンパ節腫脹の画像診断：超音波診断を中心として

• Published in: 日本口腔外科学会雑誌 Vol. 70; no. 2; pp. 42 - 48
• Main Authors: 新國, 農, 林, 孝文, 西山, 秀昌
• Format: Journal Article
• Language: Japanese
• Published: 公益社団法人 日本口腔外科学会 20.02.2024
• Subjects: リンパ節; リンパ節腫脹; 画像診断; 超音波診断; 頸部リンパ節転移
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.70.42

Lymphadenopathy is one of the representative findings of cervical lymph node pathology. Its causes are roughly classified into inflammatory (infectious and reactive), neoplastic (lymph node metastasis, malignant lymphoma, etc.), and others (IgG4-related diseases, etc.). To obtain the diagnosis, various imaging modalities such as CT, MRI, PET and ultrasonography are routinely used. Among them, ultrasonography is widely used for the follow-up study because of its low-cost and no ionizing radiation. In our institution, we visualize and store the still images of the regional lymph nodes (minimal axial diameter of about 3 mm or more）in the submental, the submandibular, the upper deep cervical, the middle deep cervical regions and evaluate other areas as needed. Generally, cervical lymph nodes can be modeled as elliptical shape, and the maximal diameter, minimal diameter and thickness are definable. In our diagnostic report of follow-up period, the maximal axial diameter (the largest), minimal axial diameter (the shortest), and overall morphology are compared with the previous examination. Additionally, with regard to the internal structure of the lymph nodes, we evaluate the emergence and time-course changes of hyper/anechoic (or mixed) area, and the state of blood flow with Doppler and tissue stiffness with strain elastography as appropriate. In this article, the roll of ultrasonography in the modern imaging techniques for the diagnosis of cervical lymphadenopathy including non-neoplastic pathology is discussed.