Ultrasound characteristics of cervical lymph nodes in children with infectious mononucleosis

Abstract

Aim: To illustrate ultrasonographic characteristics of cervical lymph nodes in children with infectious mononucleosis (IM).

Material and methods: Ultrasonographic characteristics of cervical lymph nodes in 61 children with IM were retrospectively analyzed, including the location, long diameter (LD), short diameter (SD), short-to-long diameter ratio (S/L), boundary clarity, presence of lymphatic hilum, internal hyperechoic features, blood supply mode and vascular richness.

Results: The 61 children with IM comprised 41 males and 20 females, with an average age of 7.2±3.8 years. Bilateral enlargement of cervical lymph nodes was a typical ultrasonographic manifestation of IM. Lymph node enlargement was evenly distributed on both sides of the neck. All enlarged lymph nodes were in neck zone II, with an average S/L ratio of 0.37±0.07, long diameter 33.4±6.4 mm, and short diameter 12.1±2.5 mm. Other typical ultrasonographic characteristics of cervical lymph nodes in children with IM included clear borders (100%), beads-on-a-string (98.4%), smooth edges (98.4%), visible lymphatic hila (95.1%), loose arrangement of lymphatic hila (88.5%), central blood flow signals (96.7%), and vascular richness (82.0%). 

Conclusions: IM children present unique ultrasonographic characteristics of cervical lymph nodes, which may assist in the early and timely diagnosis of pediatric IM in clinical practice.