Normal mesenteric lymph nodes

A.Prof Frank Gaillard et al.

Mesenteric lymph nodes had, during the era of single thick slice CT been only really appreciated when enlarged. With the advent of multidetector volume acquisition CT (and especially coronal reformats) they are commonly seen in normal individual and thus have raised the obvious question of what constitutes enlarged. As with all such questions (e.g size of common bile duct, size of pancreatic duct etc.), it is really a statistical question determined by:

  • size distribution of normal nodes
  • size distribution of pathological nodes
  • desired sensitivity and specificity

As there is clearly overlap to some degree between the size of normal and abnormal nodes the literature is replete with various figures. Various upper limit of normal for short axis diameter include 1:  

  • 3 mm: too conservative, with 39% of normal individuals having nodes larger than this
  • 4-5 mm: probably a reasonable compromise 1-2
  • 9-11 mm: may miss many abnormal nodes

The other factor to consider is the number of nodes, which may be elevated in patients with some haematological disorders without clearly being abnormal in size ref needed.

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rID: 13639
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