Академический Документы
Профессиональный Документы
Культура Документы
Pictorial Essay
Anil T. Ahuja1
Michael Ying2
Sonographic Evaluation of Cervical
Ahuja AT, Yi
Lymph Nodes
OBJECTIVE. Sonography is a useful imaging tool in the evaluation of cervical lymph
nodes. Gray-scale sonography and color and power Doppler sonography are commonly used
in clinical practice. This article documents the common sonographic appearances of different
causes of cervical lymphadenopathy.
CONCLUSION. The sonographic appearances of normal nodes differ from those of ab-
normal nodes. Sonographic features that help to identify abnormal nodes include shape
(round), absent hilus, intranodal necrosis, reticulation, calcification, matting, soft-tissue
edema, and peripheral vascularity.
etastatic cervical lymph nodes vascular resistance of lymph nodes can also
Fig. 1.—Schematic diagram of neck shows classification of cervical lymph nodes in sonography examinations.
A B
nodes usually show low vascular resistance Malignant Lymph Nodes phy is a useful sign to indicate focal tumor
(resistive index [RI] and pulsatility index Malignant lymph nodes include meta- infiltration (Fig. 5B). Lymph nodes with
[PI]) [6] (Fig. 4). Inflammation causes va- static and lymphomatous nodes. On gray- cystic necrosis are suggestive of malig-
sodilatation, which increases blood flow scale sonography, metastatic nodes are usu- nancy, and intranodal cystic necrosis is com-
velocity in reactive lymph nodes. It may ex- ally hypoechoic, round, and without mon in metastatic nodes from squamous cell
plain the low vascular resistance in reactive echogenic hilus (Fig. 5A). Coagulation ne- carcinomas (Fig. 5C).
lymph nodes given that high blood flow ve- crosis, which appears as a demarcated A proven metastatic lymph node with ill-
locity is always associated with a lower echogenic focus, may be found in metastatic defined borders may suggest extracapsular
vascular resistance. nodes (Fig. 5A). Eccentric cortical hypertro- spread and patients may have a poor progno-
A B
sis (Fig. 5D). Metastatic nodes from papil- echogenic hilus and tend to show intranodal RI and PI values [8] (Fig. 9). In metastatic
lary carcinoma of the thyroid may be reticulation [9] (Fig. 6). nodes, blood vessels within the nodes are com-
hyperechoic compared with adjacent mus- On color Doppler, power Doppler, and 3D pressed by tumor cells, which grow and spread
cles and have punctate calcifications [8] sonography, metastatic and lymphomatous and replace a large portion of the lymph node,
(Fig. 5E). In Hodgkin’s lymphoma and nodes usually show peripheral (Fig. 7) or mixed resulting in an increase in vascular resistance.
non-Hodgkin’s lymphoma, lymph nodes (Fig. 8) vascularity. On spectral Doppler sonog- Gray-scale sonography has a sensitivity of
tend to be round, hypoechoic, and without raphy, malignant lymph nodes tend to have high 95% and a specificity of 83% in differentiating
A B
Fig. 4.—53-year-old man with confirmed reactive lymph nodes in neck.
A, Spectral Doppler sonogram shows low vascular resistance of lymph node with resistive index (RI) of 0.59 and pulsatility index (PI) of 0.94, which are lower than cutoff values
commonly used to differentiate benign and malignant nodes (RI, 0.7; PI, 1.5).
B, Longitudinal gray-scale sonogram of same lymph node as in A shows lymph node is hypoechoic and oval (arrows). Arrowheads indicate echogenic hilus where blood
vessels enter and leave lymph node.
A B
C D
A B
A B
Fig. 8.—43-year-old man with proven non-Hodgkin’s lymphomatous nodes in posterior triangle.
A, Color Doppler sonogram shows lymphomatous node with both hilar (arrows) and peripheral (arrowhead) vascularity.
B, Power Doppler sonogram of same lymph node as in A shows hilar (arrows) and peripheral (arrowheads) vascularity similar to that seen in A.
A B
Fig. 10.—Gray-scale sonograms of two patients with proven tuberculous lymphadenitis.
A, Image of 59-year-old woman shows two tuberculous nodes (arrows) matted together without normal intervening soft tissues. Note cystic necrosis within lymph nodes
(arrowheads), which is common in tuberculous lymphadenitis.
B, Image of 31-year-old woman shows hypoechoic and round tuberculous node in posterior triangle (arrows) with adjacent soft-tissue edema (arrowheads), which is common
in tuberculous lymphadenitis.
A B
A B
Fig. 12.—30-year-old woman with palpable nodes in upper cervical region proven to be Kikuchi’s disease. (Reprinted with permission from [12])
A, Gray-scale sonogram of upper cervical node (small arrows) shows node is hypoechoic and elliptic and has echogenic hilus (arrowheads). Large arrows indicate common
carotid artery, and asterisk indicates internal jugular vein. Note gray-scale sonographic appearance of lymph nodes in Kikuchi’s disease is similar to that of reactive nodes.
B, Power Doppler sonogram of same lymph node as in A (arrows) reveals that lymph node involved with Kikuchi’s disease shows hilar vascularity (arrowheads) that is similar
to vascular pattern of reactive lymph nodes.
A B
Fig. 13.—42-year-old man with palpable nodes in submandibular area that were subsequently proven to be Kimura’s disease.
A, Gray-scale sonogram shows submandibular lymph node (arrows) is hypoechoic, is round, and has echogenic hilus (arrowheads). Gray-scale sonographic appearance
is similar to that of reactive nodes except that lymph nodes in Kimura’s disease tend to be round and are located in the vicinity of the salivary glands.
B, Power Doppler sonogram of same lymph node as in A (arrows) shows extensive hilar vascularity (arrowheads), which is similar to vascular pattern of reactive lymph nodes.
A B
Fig. 14.—13-year-old boy with palpable nodes in submental and submandibular areas that were subsequently proven to be Rosai-Dorfman disease.
A, Gray-scale sonogram shows two submental nodes that are hypoechoic, round, and without echogenic hilus (arrows). Sonographic appearance is similar to that of malig-
nant nodes.
B, Power Doppler sonogram of same submental node as in A shows peripheral vascularity (arrows), which is similar to malignant lymph nodes.
metastatic and reactive nodes [10]. Color or out echogenic hilus and tend to show intranodal Unusual Lymphadenopathy
power Doppler sonography is essential and cystic necrosis, nodal matting, and adjacent Diseases such as Kikuchi’s disease (histio-
useful to patients when gray-scale sonogra- soft-tissue edema [8] (Fig. 10). On color Dop- cytic necrotizing lymphadenitis), Kimura’s
phy is equivocal. In one study, power Doppler pler, power Doppler, and 3D sonography, the disease (eosinophilic hyperplastic lymphogranu-
sonography aided in the diagnosis of 5% of vascular distribution of tuberculous nodes is loma), and Rosai-Dorfman disease (sinus histi-
patients with metastatic nodes and 17% of pa- varied and simulates benign and malignant ocytosis with massive lymphadenopathy) may
tients with reactive nodes [10]. nodes. However, displacement of hilar vascu- show benign and inflammatory lymphadenopa-
larity is common in tuberculous nodes and is thy in the neck. Kikuchi’s disease is a self-lim-
Tuberculous Lymph Nodes due to the high incidence of intranodal cystic ne- iting and benign lymphadenitis in which
On gray-scale sonography, tuberculous crosis, which displaces the vessels, in tubercu- cervical nodes are usually affected. Kimura’s
nodes tend to be hypoechoic, round, and with- lous nodes [11] (Fig. 11). disease is an autoimmune eosinophilic granulo-
matous disorder with generalized lymphaden- Because the sonographic appearance of these 7. van den Brekel MW, Castelijns JA, Stel HV,
opathy. Rosai-Dorfman disease is a rare unusual lymphadenopathies is similar to that Golding RP, Meyer CJ, Snow GB. Modern imag-
ing techniques and ultrasound-guided aspiration
idiopathic benign histiocytic proliferation, and of reactive or malignant nodes, the diagnosis is
cytology for the assessment of neck node me-
massive lymphadenopathy is usually found in still based on histology. tastases: a prospective comparative study. Eur
the neck region with predominant sinusoidal Arch Otorhinolaryngol 1993;250:11–17
histiocyte infiltration. 8. Ahuja A, Ying M. Sonography of neck lymph
On sonography, lymph nodes involved with References nodes. II. Abnormal lymph nodes. Clin Radiol
Downloaded from www.ajronline.org by 172.69.23.45 on 08/22/18 from IP address 172.69.23.45. Copyright ARRS. For personal use only; all rights reserved
Kikuchi’s and Kimura’s diseases have an ap- 1. Baatenburg de Jong RJ, Rongen RJ, Lameris JS, 2003;58:359–366
pearance similar to that of reactive nodes, Harthoorn M, Verwoerd CD, Knegt P. Metastatic 9. Ahuja AT, Ying M, Yuen HY, Metreweli C.
neck disease: palpation vs ultrasound examina- ‘Pseudocystic’ appearance of non-Hodgkin’s
which tend to be hypoechoic, and have an tion. Arch Otolaryngol Head Neck Surg lymphomatous nodes: an infrequent finding with
echogenic hilus. In patients with Kikuchi’s dis- 1989;115:689–690 high-resolution transducers. Clin Radiol
ease, lymph nodes are usually oval (Fig. 12A), 2. Ying M, Ahuja AT, Evans R, King W, Metreweli 2001;56:111–115
whereas lymph nodes in patients with C. Cervical lymphadenopathy: sonographic dif- 10. Ahuja A, Ying M. Sonographic evaluation of cer-
Kimura’s disease are usually round (Fig. 13A). ferentiation between tuberculous nodes and nodal vical lymphadenopathy: is power Doppler sonog-
On power Doppler sonography [12, 13], lymph metastases from non-head and neck carcinomas. J raphy routinely indicated? Ultrasound Med Biol
Clin Ultrasound 1998;26:383–389 2003;29:353–359
nodes in patients with Kikuchi’s disease and
3. Som PM. Detection of metastasis in cervical 11. Ahuja A, Ying M, Yuen YH, Metreweli C.
Kimura’s disease tend to show hilar vascular- lymph nodes: CT and MR criteria and differential Power Doppler sonography to differentiate tu-
ity [12, 13] (Figs. 12B and 13B). In patients diagnosis. AJR 1992;158:961–969 berculous cervical lymphadenopathy from na-
with Rosai-Dorfman disease, involved lymph 4. Lee YY, Van Tassel P, Nauert C, North LB, Jing sopharyngeal carcinoma. AJNR 2001;22:735–
nodes appear similar to malignant nodes, BS. Lymphomas of the head and neck: CT findings 740
which are hypoechoic, round, and without at initial presentation. AJR 1987;149:575–581 12. Ying M, Ahuja AT, Yuen HY. Grey-scale and
5. Reede DL, Bergeron RT. Cervical tuberculous power Doppler sonography of unusual cervical
echogenic hilus (Fig. 14A). On power Doppler
adenitis: CT manifestations. Radiology 1985;154: lymphadenopathy. Ultrasound Med Biol
sonography, involved lymph nodes in Rosai- 701–704 2004;30:449–454
Dorfman disease also have an appearance sim- 6. Ying M, Ahuja A. Sonography of neck lymph 13. Ahuja A, Ying M, Mok JS, Anil CM. Gray scale
ilar to that of malignant nodes and show pe- nodes. I. Normal lymph nodes. Clin Radiol and power Doppler sonography in cases of
ripheral or mixed vascularity [12] (Fig. 14B). 2003;58:351–358 Kimura disease. AJNR 2001;22:513–517
1. Anmol Gupta Bansal, Rebecca Oudsema, Joy A. Masseaux, Henrietta Kotlus Rosenberg. 2018. US of Pediatric Superficial Masses
of the Head and Neck. RadioGraphics 38:4, 1239-1263. [Crossref]
2. Minsu Kwon, Chaedong Yim, Hye Jin Baek, Jong Sil Lee, Ji-Hyun Seo, Jin Pyeong Kim, Seung Hoon Woo, Jung Je Park. 2018.
Ultrasonography-guided core needle biopsy of cervical lymph nodes for diagnosing head and neck lymphoma compared with open
surgical biopsy: Exploration for factors that shape diagnostic yield. American Journal of Otolaryngology . [Crossref]
Downloaded from www.ajronline.org by 172.69.23.45 on 08/22/18 from IP address 172.69.23.45. Copyright ARRS. For personal use only; all rights reserved
3. Farhoud Faraji, Stephanie F. Coquia, Meghan B. Wenderoth, Ericka S. Padilla, Dana Blitz, M. Robert DeJong, Nafi Aygun,
Ulrike M. Hamper, Carole Fakhry. 2018. Evaluating oropharyngeal carcinoma with transcervical ultrasound, CT, and MRI. Oral
Oncology 78, 177-185. [Crossref]
4. Hussein Okasha, Shaimaa Elkholy, Mohamed Sayed, Mohamed El-Sherbiny, Ramy El-Hussieny, Emad El-Gemeie, Waleed Al-
Nabawy, Moustafa Saeed Mohamed, Yahia Elsherif. 2018. Ultrasound, endoscopic ultrasound elastography, and the strain ratio
in differentiating benign from malignant lymph nodes. Arab Journal of Gastroenterology 19:1, 7-15. [Crossref]
5. Ashish Lal Shrestha, Pradita Shrestha. 2018. Peripheral Lymph Node Excisional Biopsy: Yield, Relevance, and Outcomes in a
Remote Surgical Setup. Surgery Research and Practice 2018, 1. [Crossref]
6. E. Papini, R. Guglielmi, G. Bizzarri, A. Frasoldati. Nonisotopic Thyroid Imaging 89-123. [Crossref]
7. Ki Eon Kwon, Seon-Jeong Kim, Hyun Jeong Choi, Yoon Yang Jung, Noh Hyuck Park, Ji Yeon Park, Soo Heui Baek. 2017.
Sonographic appearance of an eccrine spiradenoma: A case report. Journal of Clinical Ultrasound 27. . [Crossref]
8. Ramanujam Prativadi, Nirvikar Dahiya, Aya Kamaya, Shweta Bhatt. 2017. Chapter 5 Ultrasound Characteristics of Benign vs
Malignant Cervical Lymph Nodes. Seminars in Ultrasound, CT and MRI 38:5, 506-515. [Crossref]
9. R. Venkata Ramanan, A. Pudhiavan, A. Venkataramanan. 2017. The “cluster of black pearls” sign of sarcoid lymphadenopathy:
a new sign on thin-section contrast-enhanced multidetector CT. Clinical Radiology 72:9, 729-736. [Crossref]
10. Wynne Yuru Chua, Jill E. Langer, Lisa P. Jones. 2017. Surveillance Neck Sonography After Thyroidectomy for Papillary Thyroid
Carcinoma: Pitfalls in the Diagnosis of Locally Recurrent and Metastatic Disease. Journal of Ultrasound in Medicine 36:7,
1511-1530. [Crossref]
11. Aditya C. Davé, Lisa J. Zekas, Danelle M. Auld. 2017. Correlation of cytologic and histopathologic findings with perinodal
echogenicity of abdominal lymph nodes in dogs and cats. Veterinary Radiology & Ultrasound 58:4, 463-470. [Crossref]
12. Diederik J. Grootendorst, Raluca M. Fratila, Joost Pouw, Bennie Ten Haken, Richard J.A. Van Wezel, Sven Rottenberg, Wiendelt
Steenbergen, Srirang Manohar, Theo J.M. Ruers. 2017. Photoacoustic staging of nodal metastases using SPIOs: Comparison
between in vivo, in toto and ex vivo imaging in a rat model. Biomedical Spectroscopy and Imaging 5:1, 71-87. [Crossref]
13. Hussein Okasha, Shaimaa Elkholy, Mohamed Sayed, Ahmed Salman, Yahia Elsherif, Emad El-Gemeie. 2017. Endoscopic
ultrasound-guided fine-needle aspiration and cytology for differentiating benign from malignant lymph nodes. Arab Journal of
Gastroenterology 18:2, 74-79. [Crossref]
14. Deborah MacFarlane, Komal Shah, Ashley Wysong, Ximena Wortsman, Tatyana R. Humphreys. 2017. The role of imaging in the
management of patients with nonmelanoma skin cancer. Journal of the American Academy of Dermatology 76:4, 579-588. [Crossref]
15. Angel Rollon-Mayordomo, Teresa Creo-Martinez, Yolanda Marin-Lapeira, Juan-Andres Rodriguez-Ruiz, Pedro Infante-Cossio.
2017. Preoperative ultrasonography for evaluation of clinically N0 neck in oral cavity carcinoma. Journal of Cranio-Maxillofacial
Surgery 45:3, 420-426. [Crossref]
16. Maria Regina Marrocos Machado, Marcos Roberto Tavares, Carlos Alberto Buchpiguel, Maria Cristina Chammas. 2017.
Ultrasonographic Evaluation of Cervical Lymph Nodes in Thyroid Cancer. Otolaryngology-Head and Neck Surgery 156:2, 263-271.
[Crossref]
17. Gitta Madani. Imaging of Salivary Glands 668-685. [Crossref]
18. Robert Gürkov. 2017. Mit Wissen und Übung zu präzisen Sonografiebefunden. HNO Nachrichten 47:6, 33. [Crossref]
19. Leyla Acu, Suna Özhan Oktar, Rusen Acu, Cem Yücel, Süleyman Cebeci. 2016. Value of Ultrasound Elastography in the
Differential Diagnosis of Cervical Lymph Nodes. Journal of Ultrasound in Medicine 35:11, 2491-2499. [Crossref]
20. Ana Célia Baptista Koifman. 2016. Normal, abnormal, and inconclusive: has the ultrasound pattern of healthy cervical lymph
nodes been defined?. Radiologia Brasileira 49:5, IX-IX. [Crossref]
21. Inseon Ryoo, Sangil Suh, Sung-Hye You, Hae Young Seol. 2016. Usefulness of Microvascular Ultrasonography in Differentiating
Metastatic Lymphadenopathy from Tuberculous Lymphadenitis. Ultrasound in Medicine & Biology 42:9, 2189-2195. [Crossref]
22. 2016. AIUM Practice Parameter for the Performance of a Thyroid and Parathyroid Ultrasound Examination. Journal of Ultrasound
in Medicine 35:9, 1-11. [Crossref]
23. Derek B. Allison, Zahra Maleki. 2016. HPV-related head and neck squamous cell carcinoma: An update and review. Journal of
the American Society of Cytopathology 5:4, 203-215. [Crossref]
24. Yoav Amitai, Tehillah Menes, Galit Aviram, Orit Golan. 2016. Do All Women With Abnormal Sonographic Axillary Lymph
Nodes Need a Biopsy?†. Canadian Association of Radiologists Journal 67:2, 173-178. [Crossref]
25. Cheng Xie, Peter Cox, Nia Taylor, Sarah LaPorte. 2016. Ultrasonography of thyroid nodules: a pictorial review. Insights into
Imaging 7:1, 77-86. [Crossref]
26. Florian Desmots, Nicolas Fakhry, Julien Mancini, Anthony Reyre, Vincent Vidal, Alexis Jacquier, Laure Santini, Guy Moulin,
Downloaded from www.ajronline.org by 172.69.23.45 on 08/22/18 from IP address 172.69.23.45. Copyright ARRS. For personal use only; all rights reserved
Arthur Varoquaux. 2016. Shear Wave Elastography in Head and Neck Lymph Node Assessment: Image Quality and Diagnostic
Impact Compared with B-Mode and Doppler Ultrasonography. Ultrasound in Medicine & Biology 42:2, 387-398. [Crossref]
27. Jianwen Du, Xianshu Bai, Yue Lu, Haili Wang, Jingjie Zhao, Jianwei Liu, Hong Wang, Xin Sui, Qinmao Fang. 2016. Diagnostic
Efficacy of Ultrasonographic Characteristics of Thyroid Carcinoma in Predicting Cervical Lymph Node Metastasis. Ultrasound
in Medicine & Biology 42:1, 68-74. [Crossref]
28. Marc Gregory Yu, Jenny Maureen Atun. 2016. Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant
Papillary Thyroid Carcinoma. Case Reports in Medicine 2016, 1. [Crossref]
29. Derek B. Allison, James A. Miller, Stephanie F. Coquia, Zahra Maleki. 2016. Ultrasonography-guided fine-needle aspiration with
concurrent small core biopsy of neck masses and lymph nodes yields adequate material for HPV testing in head and neck squamous
cell carcinomas. Journal of the American Society of Cytopathology 5:1, 22-30. [Crossref]
30. Simona Dumitra, Maria Trailescu, Amelia Burlea, Claudia Covaci, Ozana Balan, Adrian Pavel, Carmen Crișan. 2016. From Benign
to Malign in a Case of Cervical Adenopathy in a 17-Year-Old Adolescent: Diagnostic Traps. Case Reports in Pediatrics 2016,
1-4. [Crossref]
31. E. Papini, R. Guglielmi, G. Bizzarri, A. Frasoldati. Non-isotopic Thyroid Imaging 1-36. [Crossref]
32. Alex P. S. Kirkham. Radiological Imaging in Penile Cancer 89-114. [Crossref]
33. Tadataka Tsuji, Koichi Satoh, Hiroshi Nakano, Yoshiya Nishide, Yasuhiro Uemura, Susumu Tanaka, Mikihiko Kogo. 2015.
Predictors of the necessity for lymph node biopsy of cervical lymphadenopathy. Journal of Cranio-Maxillofacial Surgery 43:10,
2200-2204. [Crossref]
34. N. Nasrollah, P. Trimboli, D. Bianchi, S. Taccogna. 2015. Neck schwannoma diagnosed by core needle biopsy: a case report.
Journal of Ultrasound 18:4, 407-410. [Crossref]
35. Lei Wang, Weihua Wu, Yunqian Hu, Jiajun Teng, Runbo Zhong, Baohui Han, Jiayuan Sun. 2015. Sonographic Features of
Endobronchial Ultrasonography Predict Intrathoracic Lymph Node Metastasis in Lung Cancer Patients. The Annals of Thoracic
Surgery 100:4, 1203-1209. [Crossref]
36. Hizuru Osanai, Hiroko Kuroiwa, Keiichi Uchida, Hideaki Kagami, Kazuhiro Yamada, Akira Taguchi. 2015. Sonographic
appearances of cervical lymph nodes in healthy young Japanese adults: Association with age, sex, and body mass index. Journal
of Clinical Ultrasound 43:5, 295-301. [Crossref]
37. Lavinia Manuela Lenghel, Carolina Botar Jid, Sorana D. Bolboaca, Cristiana Ciortea, Dan Vasilescu, Grigore Baciut, Sorin M.
Dudea. 2015. Comparative study of three sonoelastographic scores for differentiation between benign and malignant cervical
lymph nodes. European Journal of Radiology 84:6, 1075-1082. [Crossref]
38. Basel Al Kadah, Hristo Hristov Popov, Bernhard Schick, Dirk Knöbber. 2015. Cervical lymphadenopathy: study of 251 patients.
European Archives of Oto-Rhino-Laryngology 272:3, 745-752. [Crossref]
39. Jessica S. Stern, Daniel T. Ginat, Jennifer L. Nicholas, Maura E. Ryan. 2015. Imaging of Pediatric Head and Neck Masses.
Otolaryngologic Clinics of North America 48:1, 225-246. [Crossref]
40. Inseon Ryoo, Sangil Suh, Young Hen Lee, Hyung Suk Seo, Hae Young Seol. 2015. Comparison of Ultrasonographic Findings
of Biopsy-Proven Tuberculous Lymphadenitis and Kikuchi Disease. Korean Journal of Radiology 16:4, 767. [Crossref]
41. F. Eberhardt, C. Köhler, K. Winter, M. Alef, I. Kiefer. 2015. Sonographically detectable changes in abdominal lymph nodes in
dogs with malignant lymphoma. Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere 43:5, 309-316. [Crossref]
42. Takehiro Izumo, Shinji Sasada, Christine Chavez, Yuji Matsumoto, Takaaki Tsuchida. 2014. Endobronchial Ultrasound
Elastography in the Diagnosis of Mediastinal and Hilar Lymph Nodes. Japanese Journal of Clinical Oncology 44:10, 956-962.
[Crossref]
43. Mohamed Mohamed Hefeda, Manal Ezat Badawy. 2014. Can ultrasound elastography distinguish metastatic from reactive lymph
nodes in patients with primary head and neck cancers?. The Egyptian Journal of Radiology and Nuclear Medicine 45:3, 715-722.
[Crossref]
44. Hans-Peter Weskott, Sanshan Yin. 2014. Ultrasonography in the Assessment of Lymph Node Disease. Ultrasound Clinics 9:3,
351-371. [Crossref]
45. Ahmad Sabry Ragheb, Hossam Mansour Abdel Rahman, Ahmed A. Azeem Ismail, Nashwa Nawar. 2014. Can diffusion weighted
image and apparent diffusion coefficient (ADC) differentiate benign from malignant cervical adenopathy?. The Egyptian Journal
of Radiology and Nuclear Medicine 45:2, 377-386. [Crossref]
46. D. King, J. Ramachandra, D. Yeomanson. 2014. Lymphadenopathy in children: refer or reassure?. Archives of Disease in Childhood
- Education and Practice 99:3, 101-110. [Crossref]
Downloaded from www.ajronline.org by 172.69.23.45 on 08/22/18 from IP address 172.69.23.45. Copyright ARRS. For personal use only; all rights reserved
47. Byung Woo Jhun, Sang-Won Um, Gee Young Suh, Man Pyo Chung, Hojoong Kim, O Jung Kwon, Joungho Han, Kyung-
Jong Lee. 2014. Clinical Value of Endobronchial Ultrasound Findings for Predicting Nodal Metastasis in Patients with Suspected
Lymphadenopathy: A Prospective Study. Journal of Korean Medical Science 29:12, 1632. [Crossref]
48. Hye Jin Yoo. 2014. Sonographic Features of Common Soft Tissue Masses in the Extremities. Journal of the Korean Orthopaedic
Association 49:6, 422. [Crossref]
49. Chintamaneni Raja Lakshmi, M. Sudhakara Rao, A. Ravikiran, Sivan Sathish, Sujana Mulk Bhavana. 2014. Evaluation of
Reliability of Ultrasonographic Parameters in Differentiating Benign and Metastatic Cervical Group of Lymph Nodes. ISRN
Otolaryngology 2014, 1-7. [Crossref]
50. Yu-Shih Lai, Chun-Ying Kuo, Mu-Kuan Chen, Hui-Chuan Chen. 2013. Three-dimensional doppler ultrasonography in assessing
nodal metastases and staging head and neck cancer. The Laryngoscope 123:12, 3037-3042. [Crossref]
51. 2013. AIUM Practice Guideline for the Performance of a Thyroid and Parathyroid Ultrasound Examination. Journal of Ultrasound
in Medicine 32:7, 1319-1329. [Crossref]
52. Slađana Petrović, Maja Jocić, Dragan Stojanov. 2013. APPLICATION OF IMAGING METHODS IN THE DIAGNOSTICS
OF MALIGNANT NECK LYMPH NODES. Acta medica medianae 45-50. [Crossref]
53. Craig P. Giacomini, R. Brooke Jeffrey, Lewis K. Shin. 2013. Ultrasonographic Evaluation of Malignant and Normal Cervical
Lymph Nodes. Seminars in Ultrasound, CT and MRI 34:3, 236-247. [Crossref]
54. F.J. Caballero Mora, J. Pozo Román, A.I. Jiménez Ortega, J.M. Ollero Caprani, J. Argente. 2013. Linfadenitis cervical simulando
un bocio. Anales de Pediatría 78:5, 337-338. [Crossref]
55. A. Ulu-Kilic, G. Gulen, F. Sezen, S. Kilic, I. Sencan. 2013. Tularemia in Central Anatolia. Infection 41:2, 391-399. [Crossref]
56. Michael Secko, Andrew Aherne. 2013. Diagnosis of Bezold Abscess Using Bedside Ultrasound. The Journal of Emergency Medicine
44:3, 670-672. [Crossref]
57. Yorihisa Orita, Soichiro Nose, Yasuharu Sato, Kentaro Miki, Shuhei Domae, Misato Hirai, Yasuyuki Noyama, Kazuo Hamaya,
Norio Kasai, Kazunori Nishizaki, Tadashi Yoshino. 2013. Cervical lymph node extirpation for the diagnosis of malignant
lymphoma. Surgery Today 43:1, 67-72. [Crossref]
58. Emad H. Kandil, Salem I. Noureldine, Ralph P. Tufano. Extensive Surgery for Thyroid Cancer 67-77. [Crossref]
59. Thomas C. Bryson, Gaurang V. Shah, Ashok Srinivasan, Suresh K. Mukherji. 2012. Cervical Lymph Node Evaluation and
Diagnosis. Otolaryngologic Clinics of North America 45:6, 1363-1383. [Crossref]
60. Benjamin J. Ludwig, Jimmy Wang, Rohini N. Nadgir, Naoko Saito, Ilse Castro-Aragon, Osamu Sakai. 2012. Imaging of Cervical
Lymphadenopathy in Children and Young Adults. American Journal of Roentgenology 199:5, 1105-1113. [Abstract] [Full Text]
[PDF] [PDF Plus]
61. GERALD SCHMID-BINDERT, HONGBIN JIANG, GEORG KÄHLER, JOACHIM SAUR, THOMAS HENZLER, HAO
WANG, SHENGXIANG REN, CAICUN ZHOU, LOTHAR R. PILZ. 2012. Predicting malignancy in mediastinal lymph nodes
by endobronchial ultrasound: A new ultrasound scoring system. Respirology 17:8, 1190-1198. [Crossref]
62. Cristina Beléndez Bieler, Jimena Pérez-Moreno, Jesús Saavedra Lozano. 2012. Adenomegalias. Adenitis cervical. Anales de Pediatría
Continuada 10:6, 313-323. [Crossref]
63. Mitchell A. Chess, Apeksha Chaturvedi, A. Luana Stanescu, Johan G. Blickman. 2012. Emergency Pediatric Ear, Nose, and
Throat Imaging. Seminars in Ultrasound, CT and MRI 33:5, 449-462. [Crossref]
64. I. Ghfir, W. Bellaoui, R. Ouboukdir, F. M’hamdi, I. El Mesbahi, F. Serroukh, O. Boumaaza, A. Mouaden, H. Guerrouj, N. Ben
Raïs Aouad. 2012. Lymphadénite tuberculeuse cervicale simulant une métastase ganglionnaire d’un carcinome papillaire de la
thyroïde. À propos d’un cas. Médecine Nucléaire 36:10, 637-639. [Crossref]
65. Amanda S. Corey, Patricia A. Hudgins. 2012. Radiographic Imaging of Human Papillomavirus Related Carcinomas of the
Oropharynx. Head and Neck Pathology 6:S1, 25-40. [Crossref]
66. Ignasi Garcia-Olivé, Joaquim Radua, Pere Serra, Felipe Andreo, Jose Sanz-Santos, Eduard Monsó, Antoni Rosell, Enrique Cases-
Viedma, Alberto Fernández-Villar, Manuel Núñez-Delgado, Ricardo García-Luján, Josep Morera, Juan Ruiz-Manzano. 2012.
Intra- and Interobserver Agreement Among Bronchial Endosonographers for the Description of Intrathoracic Lymph Nodes.
Ultrasound in Medicine & Biology 38:7, 1163-1168. [Crossref]
67. Cheng-Ping Wang, Tseng-Cheng Chen, Pei-Jen Lou, Tsung-Lin Yang, Ya-Ling Hu, Ming-Jium Shieh, Jenq-Yuh Ko, Tzu-
Yu Hsiao. 2012. Neck ultrasonography for the evaluation of the etiology of adult unilateral vocal fold paralysis. Head & Neck
34:5, 643-648. [Crossref]
68. Jeffrey M. Bumpous, Gregory W. Randolph. 2012. The Expanding Utility of Office-Based Ultrasound for the Head and Neck
Surgeon. Ultrasound Clinics 7:2, 191-195. [Crossref]
Downloaded from www.ajronline.org by 172.69.23.45 on 08/22/18 from IP address 172.69.23.45. Copyright ARRS. For personal use only; all rights reserved
69. H.-P. Weskott. 2012. Ultraschall in der Diagnostik maligner Lymphome. Der Radiologe 52:4, 347-359. [Crossref]
70. Phan Nguyen. 2012. Optical Differentiation Between Malignant and Benign Lymphadenopathy by Grey Scale Texture Analysis
of Endobronchial Ultrasound Convex Probe Images. CHEST Journal 141:3, 709. [Crossref]
71. Cindy Chavez, Eitan Dickman, Lawrence Haines. 2012. The use of bedside ultrasonography in the evaluation of a neck mass.
The American Journal of Emergency Medicine 30:2, 389.e3-389.e4. [Crossref]
72. Eun Bi Ryu, Kyung Seung Oh, Kyung Soon Jeong. 2012. Supraclavicular Lymph Node Metastasis from Various Malignancies:
Assessment with 18F-Fluorodeoxyglucose Positron Emission Tomography/CT, Contrast-Enhanced CT and Ultrasound. Journal
of the Korean Society of Radiology 66:1, 83. [Crossref]
73. Jens Eduard Meyer, Armin Steffen, Martin Bienemann, Juergen Hedderich, Ulrike Schulz, Martin Laudien, Joachim Quetz,
Barbara Wollenberg. 2012. Evaluation and development of a predictive model for ultrasound-guided investigation of neck
metastases. European Archives of Oto-Rhino-Laryngology 269:1, 315-320. [Crossref]
74. Eun-Wook Chung, Young Soo Chang, Jungbok Lee, Sung Yong Choi, Nak Joon Lee, Yoon Kyoung So, Han-Sin Jeong. 2012.
Evaluation of Lymph Nodes in Patients with Concurrent Papillary Thyroid Carcinoma and Cervical Tuberculous Lymphadenitis.
Korean Journal of Otorhinolaryngology-Head and Neck Surgery 55:9, 571. [Crossref]
75. SM El-Khateeb, AE Abou-Khalaf, MM Farid. 2011. A prospective study of three diagnostic sonographic methods in differentiation
between benign and malignant salivary gland tumours. Dentomaxillofacial Radiology 40:8, 476-485. [Crossref]
76. Jessica S. Wang Memoli. 2011. Using Endobronchial Ultrasound Features to Predict Lymph Node Metastasis in Patients With
Lung Cancer. CHEST Journal 140:6, 1550. [Crossref]
77. Lewis G. Satterwhite, David M. Berkowitz, Christopher S. Parks, Rabih I. Bechara. 2011. Central Intranodal Vessels to
Predict Cytology During Endobronchial Ultrasound Transbronchial Needle Aspiration. Journal of Bronchology & Interventional
Pulmonology 18:4, 322-328. [Crossref]
78. L. Leenhardt, F. Borson-Chazot, M. Calzada, B. Carnaille, A. Charrié, B. Cochand-Priollet, C. Do Cao, S. Leboulleux, G. Le
Clech, G. Mansour, F. Menegaux, H. Monpeyssen, J. Orgiazzi, A. Rouxel, J.L. Sadoul, M. Schlumberger, J. Tramalloni, F.
Tranquart, J.L. Wemeau. 2011. Guide de bonnes pratiques pour l’usage de l’échographie cervicale et des techniques écho-guidées
dans la prise en charge des cancers thyroïdiens différenciés de souche vésiculaire. Annales d'Endocrinologie 72:4, H1-H26. [Crossref]
79. Yen-Yi Li, Wen-Cheng Chang, Yao-Peng Hsu, Li-Jen Liao. 2011. Ultrasound Features of Pediatric Kikuchi–Fujimoto Disease:
Report of Two Cases. Journal of Medical Ultrasound 19:3, 87-90. [Crossref]
80. D. Fischerova. 2011. Ultrasound scanning of the pelvis and abdomen for staging of gynecological tumors: a review. Ultrasound
in Obstetrics & Gynecology 38:3, 246-266. [Crossref]
81. Jung Lim Yoo, Sang-il Suh, Young Hen Lee, Hyung Suk Seo, Kyoung Min Kim, Bong Kyung Shin, Joon Young Song, Hae
Young Seol. 2011. Gray Scale and Power Doppler Study of Biopsy-Proven Kikuchi Disease. Journal of Ultrasound in Medicine
30:7, 957-963. [Crossref]
82. L. Leenhardt, F. Borson-Chazot, M. Calzada, B. Carnaille, A. Charrié, B. Cochand-Priollet, C.D. Cao, S. Leboulleux, G.
Le Clech, G. Mansour, F. Menegaux, H. Monpeyssen, J. Orgiazzi, A. Rouxel, J.L. Sadoul, M. Schlumberger, J. Tramalloni,
F. Tranquart, J.L. Wemeau. 2011. Good practice guide for cervical ultrasound scan and echo-guided techniques in treating
differentiated thyroid cancer of vesicular origin. Annales d'Endocrinologie 72:3, 173-197. [Crossref]
83. Alexander S. Jung, Gaurav Sharma, Dennis Maceri, Dale Rice, Sue Ellen Martin, Alexis B. Korostoff, Edward G. Grant. 2011.
Ultrasound-Guided Fine Needle Aspiration of Major Salivary Gland Masses and Adjacent Lymph Nodes. Ultrasound Quarterly
27:2, 105-113. [Crossref]
84. Noriaki Yamamoto, Yoshihiro Yamashita, Tatsurou Tanaka, Ayataka Ishikawa, Shinji Kito, Nao Wakasugi-Sato, Shinobu
Matsumoto-Takeda, Masafumi Oda, Ikuya Miyamoto, Kensuke Yamauchi, Shunji Shiiba, Yuji Seta, Kou Matsuo, Hirofumi Koga,
Tetsu Takahashi, Yasuhiro Morimoto. 2011. Diagnostic significance of characteristic findings on ultrasonography for the stitch
abscess after surgery in patients with oral squamous cell carcinoma. Oral Oncology 47:3, 163-169. [Crossref]
85. Eun-Jin Chung, Young-Hee Kwon, Yeo Sun Jang, Hey-Sung Baek, Ki-Seok Jang, Chan Kum Park, Jeong Seon Park, Jae Won Oh,
Ha-Baik Lee. 2011. Discrimination Between Childhood Subacute Necrotizing Lymphadenitis and Nonspecific Cervical Lymph
Hyperplasia for Earlier Diagnosis. Pediatric Allergy and Respiratory Disease 21:4, 326. [Crossref]
86. Ahmed Abdel Khalek Abdel Razek, Gada Gaballa. 2011. Role of Perfusion Magnetic Resonance Imaging in Cervical
Lymphadenopathy. Journal of Computer Assisted Tomography 35:1, 21-25. [Crossref]
87. Jeffrey M. Bumpous, Gregory W. Randolph. 2010. The Expanding Utility of Office-Based Ultrasound for the Head and Neck
Surgeon. Otolaryngologic Clinics of North America 43:6, 1203-1208. [Crossref]
Downloaded from www.ajronline.org by 172.69.23.45 on 08/22/18 from IP address 172.69.23.45. Copyright ARRS. For personal use only; all rights reserved
88. Hye Jung Kim, Jin Young Kwak, Joo Wan Choi, Ji Hea Bae, Kyung Min Shin, Hui Joong Lee, Gab Chul Kim, Jin Hyang Jung,
Ji Young Park. 2010. Impact of US Surveillance on Detection of Clinically Occult Locoregional Recurrence after Mastectomy for
Breast Cancer. Annals of Surgical Oncology 17:10, 2670-2676. [Crossref]
89. Taiki Fujiwara, Kazuhiro Yasufuku, Takahiro Nakajima, Masako Chiyo, Shigetoshi Yoshida, Makoto Suzuki, Kiyoshi Shibuya,
Kenzo Hiroshima, Yukio Nakatani, Ichiro Yoshino. 2010. The Utility of Sonographic Features During Endobronchial Ultrasound-
Guided Transbronchial Needle Aspiration for Lymph Node Staging in Patients With Lung Cancer. Chest 138:3, 641-647.
[Crossref]
90. Stephen C. Kanick, Cor van der Leest, Remco S. Djamin, Andre M. Janssens, Henk C. Hoogsteden, Henricus J.C.M Sterenborg,
Arjen Amelink, Joachim G.J.V Aerts. 2010. Characterization of Mediastinal Lymph Node Physiology In Vivo by Optical
Spectroscopy during Endoscopic Ultrasound-Guided Fine Needle Aspiration. Journal of Thoracic Oncology 5:7, 981-987. [Crossref]
91. Benjamin J. Ludwig, Bryan R. Foster, Naoko Saito, Rohini N. Nadgir, Ilse Castro-Aragon, Osamu Sakai. 2010. Diagnostic
Imaging in Nontraumatic Pediatric Head and Neck Emergencies. RadioGraphics 30:3, 781-799. [Crossref]
92. Brian D. Sites, Alan J.R. Macfarlane, Vincent R. Sites, Ali M. Naraghi, Vincent W.S. Chan, John G. Antonakakis, Mandeep
Singh, Richard Brull. 2010. Clinical Sonopathology for the Regional Anesthesiologist. Regional Anesthesia and Pain Medicine
35:3, 281-289. [Crossref]
93. Young Tong Kim, Kyung-Hee Yoo, Hyun Deuk Cho, Mee-Hye Oh, Hyeong Cheol Shin. 2010. Kikuchi Disease Presented with
External Iliac Lymphadenitis in a 7-year-old Girl: A Case Report. Journal of the Korean Society of Radiology 63:5, 483. [Crossref]
94. Stephen Chad Kanick, Cor van der Leest, Joachim G. J. V. Aerts, Henk C. Hoogsteden, Slávka Kaščáková, Henricus J. C. M.
Sterenborg, Arjen Amelink. 2010. Integration of single-fiber reflectance spectroscopy into ultrasound-guided endoscopic lung
cancer staging of mediastinal lymph nodes. Journal of Biomedical Optics 15:1, 017004. [Crossref]
95. E C CHOI, W-J MOON, Y C LIM. 2009. Tuberculous cervical lymphadenitis mimicking metastatic lymph nodes from papillary
thyroid carcinoma. The British Journal of Radiology 82:982, e208-e211. [Crossref]
96. Henrietta Kotlus Rosenberg. 2009. Sonography of Pediatric Neck Masses. Ultrasound Quarterly 25:3, 111-127. [Crossref]
97. Ricardo Restrepo, Julieta Oneto, Kathleen Lopez, Kamlesh Kukreja. 2009. Head and neck lymph nodes in children: the spectrum
from normal to abnormal. Pediatric Radiology 39:8, 836-846. [Crossref]
98. R. Wagner, F. Espitalier, A. Madoz, G. Picherot, P. Bordure, O. Malard. 2009. Abcès rétro- et parapharyngés de l’enfant : facteurs
prédictifs d’échec du traitement médical. Annales d'Otolaryngologie et de Chirurgie Cervico-faciale 126:3, 112-119. [Crossref]
99. Eun Tae Park, Sang-il Suh, Hae Young Seol, Young Hen Lee, Hyung Seok Seo, Bong Kyung Shin. 2009. Sonography of Biopsy-
Proven Langerhans Cell Histiocytosis in Lymph Nodes of the Neck. Journal of Ultrasound in Medicine 28:4, 519-525. [Crossref]
100. J. Tramalloni, H. Monpeyssen, J.M. Correas, O. Hélénon. 2009. Conduite à tenir devant un nodule thyroïdien : échographie,
cytoponction. Journal de Radiologie 90:3, 362-368. [Crossref]
101. Donald V. La Barge, III, Karen L. Salzman, H. Ric Harnsberger, Lawrence E. Ginsberg, Bronwyn E. Hamilton, Richard H.
Wiggins, III, Patricia A. Hudgins. 2008. Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease): Imaging
Manifestations in the Head and Neck. American Journal of Roentgenology 191:6, W299-W306. [Abstract] [Full Text] [PDF]
[PDF Plus]
102. O. Monnet, F. Cohen, T. Lecorroller, V. Vidal, A. Jacquier, J.Y. Gaubert, J.M. Bartoli, G. Moulin. 2008. Adénopathies cervicales.
Journal de Radiologie 89:7-8, 1020-1036. [Crossref]
103. Ji Eun Ahn, Jeong Hyun Lee, Jong Sook Yi, Young Ki Shong, Seok Joon Hong, Deok Hee Lee, Choong Gon Choi, Sang Joon
Kim. 2008. Diagnostic Accuracy of CT and Ultrasonography for Evaluating Metastatic Cervical Lymph Nodes in Patients with
Thyroid Cancer. World Journal of Surgery 32:7, 1552-1558. [Crossref]
104. David Goldenberg, Shahnaz Begum, William H. Westra, Zubair Khan, James Sciubba, Sara I. Pai, Joseph A. Califano, Ralph
P. Tufano, Wayne M. Koch. 2008. Cystic lymph node metastasis in patients with head and neck cancer: An HPV-associated
phenomenon. Head & Neck 30:7, 898-903. [Crossref]
105. K.T. Wong, Y.Y.P. Lee, A.D. King, A.T. Ahuja. 2008. Imaging of cystic or cyst-like neck masses. Clinical Radiology 63:6,
613-622. [Crossref]
106. Henrietta Rosenberg, Ada Kessler. Pediatric Neck 613-643. [Crossref]
107. Mary Frates. Thyroid, Parathyroid and Other Glands 211-234. [Crossref]
108. Ying Huang, Steven Bing Hu, Rong Wu, Fan-Hua Xu. 2008. Detection of Small Inflammatory and Metastatic Lymph Nodes in
Rabbits by Sonography. Journal of Ultrasound in Medicine 27:2, 233-241. [Crossref]
109. 2007. Annexe III: Échographie cervicale. Annales d'Endocrinologie 68, 81-85. [Crossref]
Downloaded from www.ajronline.org by 172.69.23.45 on 08/22/18 from IP address 172.69.23.45. Copyright ARRS. For personal use only; all rights reserved