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Ultrasound signs of normal and pathologic lymph nodes
Medical expert of the article
Alexey Kryvenko, Medical Reviewer, Editor
Last reviewed: 06.07.2025
Last reviewed: 06.07.2025
Color duplex sonography criteria for lymph node evaluation
- Degree of vascularization
- Picture of vascular spread
- Pulsation of intranodal blood flow
Signs of normal lymph nodes
- Dimensions less than 1.5 cm
- Oblong shape (M/P ratio more than 2)
- Bright echoes in the gates
- Clear boundaries
- No vascularization is observed in color mode
Signs of malignant lymphoma
- Spherical shape (M/P ratio less than 2)
- Significant decrease in echogenicity
- Frequent absence of echo in the gate
- Clear boundaries
- Significant hypervascularization
- Arborescent intranodal vascular pattern
- Intra-node IS less than 0.8
Signs of metastatic lymph node involvement in squamous cell carcinoma
- Spherical shape of the node (M/P ratio less than 2)
- Hypoechoic regressive changes
- No echo in the gate
- Fuzzy boundaries
- Moderate vascularization
- Uneven vascular pattern
- Intra-node IS more than 0.8
Signs of acute lymphadenitis
- Oblong shape (M/P ratio more than 2)
- The cortex is slightly hypoechoic.
- Central echoes are present
- Clear boundaries
- Hypervascularization
- Presence of central vessels in the gates
- Intra-node IS less than 0.8
Signs of chronic lymphadenitis
- Oblong shape (M/P ratio significantly greater than 2)
- The cortex is slightly hypoechoic.
- Clear edges
- Vascularization is not determined.