M Ying, YYP Lee, KT Wong, VYF Leung, AT Ahuja

Abstract

Ultrasound is an ideal imaging tool for initial assessment of cervical lymph nodes in children. Grey scale ultrasound helps to evaluate the morphology of cervical nodes, whereas power Doppler ultrasound assesses the nodal vasculature. On grey scale ultrasound, useful sonographic features that help in identifying pathologic nodes include round contour, absence of echogenic hilus, intranodal necrosis, calcification, ill-defined borders, matting, and adjacent soft tissue oedema. On power Doppler ultrasound, evaluation of vascular pattern of lymph nodes helps to differentiate malignant and benign nodes. Ultrasound-guided fine-needle aspiration cytology is becoming popular in paediatric patients, and ultrasound-guided core biopsy is also possible in this group of patients under local anaesthesia. This article reviews these topics to provide an overview of ultrasonography of cervical lymphadenopathy in children.