Lymph node imaging

Last revised by Rohit Sharma on 2 Apr 2024

Citation, DOI, disclosures and article data

Citation:

Venkatesh M, Sharma R, Bell D, et al. Lymph node imaging. Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-25896

DOI:

https://doi.org/10.53347/rID-25896

Permalink:

https://radiopaedia.org/articles/25896

rID:

25896

Article created:

14 Nov 2013, Manchikanti Venkatesh

Disclosures:

At the time the article was created Manchikanti Venkatesh had no recorded disclosures.

View Manchikanti Venkatesh's current disclosures

Last revised:

2 Apr 2024, Rohit Sharma ◉

Disclosures:

At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.

View Rohit Sharma's current disclosures

Revisions:

8 times, by 4 contributors - see full revision history and disclosures

Systems:

Haematology

Sections:

Approach

Synonyms:

Imaging of lymph nodes
Imaging of nodes
Nodal imaging

Lymph node imaging is a useful technique, aiding the clinician in determining whether nodes are benign or malignant. Multiple modalities are used for the assessment and characterization of lymph nodes, each with its advantages and drawbacks.

Modalities

Ultrasound

size
number
shape
contour
internal architecture
- echotexture
- hilum
- cystic/necrotic change
- calcification
long to short axis ratio
vascularity

CT

size
shape
number
attenuation characteristics
enhancement with contrast
internal architecture
- cystic/necrotic change
- calcification

MRI

size
shape
number
cystic/necrotic change

Contrast MRI

enhancement kinetics
flow kinetics
blood volume
microvascular permeability

Diffusion-weighted imaging

pending

MR spectroscopy

adjunct technique
elevated choline levels have been associated with metastatic lymph nodes
- active research into other metabolites is ongoing

MRI with USPIO

promising adjunct technique using ultra small superparamagnetic iron oxide particles
several patterns of uptake have been defined which are helpful in the characterization of lymph nodes

Interstitial administration of lymphangiographic contrast with MRI

a different approach which helps in the visualization of the lymphatic system on MRI
helps in identification of sentinel nodes and the course of draining lymphatics

Nuclear medicine

PET

has gained importance in identifying small nodal metastases
F-18-FDG is the main radiotracer used, and it is avidly taken up by malignant cells with high rates of glycolysis