Lymph nodes ultrasound – examination of lymph nodes using ultrasound. It is used at the stage of diagnosis, differential diagnosis of primary oncological lesions of the lymphoid system, lymphogenic metastasis of tumors of other organs and systems, lymphadenopathy in specific and nonspecific infections. Allows you to determine the diameter, shape, location, structural features of individual lymph nodes, identify packages and conglomerates, assess the involvement of nearby tissues in the presence of adenopathy. As a rule, ultrasound of lymph nodes of groups 1 or 2 is performed in clinical practice.
Indications
During the scan, it is possible to assess the condition of the cervical, submandibular, axillary, supra- and subclavian, mediastinal, abdominal lymph nodes, pelvic nodes, etc. Ultrasound of lymph nodes is used at the initial stage of diagnostic search or as a clarifying study. The purpose of the procedure is diagnosis, differential diagnosis, assessment of the dynamics of the disease against the background of therapeutic measures, early detection of relapses in the long term. In clinical practice, sonography is usually prescribed when signs of local inflammation, hyperplasia and compaction of lymph nodes of unknown origin are detected during an external examination, when a patient complains of pain in the area of their location. The main indications for ultrasound of lymph nodes are suspicions of:
- Oncological lesion of the lymphoid system. The technique is used during the diagnosis and differential diagnosis of lymphosarcoma and lymphogranulomatosis, which may be accompanied by an increase in the supraclavicular, cervical, abdominal, pelvic, inguinal and mediastinal lymph nodes.
- Lymphogenic metastases. The procedure makes it possible to detect signs of damage to regional lymph nodes in malignant tumors of various organs and systems, including breast cancer, thyroid cancer, etc. The assessment of the prevalence of the oncological process makes it possible to determine the tactics of conservative therapy, the scope and necessity of surgical intervention.
- Autoimmune diseases. Scanning is performed if necessary to clarify the extent of damage to various groups of lymph nodes in sarcoidosis, rheumatoid arthritis and other autoimmune diseases, to conduct differential diagnosis with oncological and infectious pathologies.
- Infectious and inflammatory processes. With confirmed specific (syphilis, tuberculosis) or nonspecific (for example, chronic tonsillitis) infection, purulent lesions of various localization, sonography is usually not performed. The reason for the appointment of manipulation may be the preservation of signs of lymphadenitis for 8 or more weeks after the disappearance of the clinical symptoms of the underlying disease.
Contraindications
There are no age and somatic contraindications to ultrasound of lymph nodes. The method is not prescribed for violation of the integrity of the skin (abrasions, wounds) and pustular lesions in the study area. The reason is the need to apply a special gel to the skin.
Methodology of conducting
Sonography of the superficial lymph nodes is carried out without preparation. With simultaneous scanning of deep lymph nodes, ultrasound of the abdominal cavity or pelvis before the procedure, you should refrain from using products that promote gas formation. The scope of the study depends on the nature of the pathology. With malignant neoplasms, local lymphadenopathies of unclear etiology, ultrasound of the lymph nodes of a certain region is usually performed. With lymphogranulomatosis, lymphosarcoma, lymphocytic leukemia, nodes of various groups are studied.
The patient releases the examined area of the body from clothing and sits on the couch in a position that provides the best conditions for scanning a particular area. The doctor applies a special gel to the ultrasound sensor that improves the conductivity of ultrasound signals, applies the sensor to the skin and makes smooth movements. The manipulation is absolutely painless, the patient feels only the touch of the sensor and the contact of the gel on the skin. The duration of the procedure is determined by the number of groups of lymph nodes studied. In the process of sonography, the specialist clarifies the localization, number, shape, diameter and structural features of the lymph nodes, reveals the infiltration of nearby tissues.
Interpretation of results
The size of unchanged lymph nodes usually does not exceed 0.8-1 cm, the ratio of length and thickness is no more than 1:2. The contours are smooth, clear, the structure is uniform hyperechoic. The lesion of lymph nodes may be accompanied by a change in their shape, an increase in size, uneven contours, heterogeneity of structure, the formation of packages or the formation of conglomerates. The ultrasound diagnostics doctor describes all the detected changes in the conclusion and passes the document to the patient or attending physician. The conclusion is prepared within a few hours or a day, depending on the workload of the specialist.
The doctor conducting the study does not make a final diagnosis. To clarify further tactics of examination and treatment, you should contact the specialist who issued the referral for sonography. According to the results of ultrasound of lymph nodes, the attending physician can establish a diagnosis, prescribe other diagnostic procedures (biopsy, computer or magnetic resonance imaging, analysis for cancer markers, etc.), issue a referral for hospitalization or for consultations with other specialists.
