Ultrasound Study of Tubercular Lymphadenopathy

Year 2013, Volume: 38 Issue: 2, 189 - 195, 01.06.2013

Sushil Ghanshyam Kachewar Smita Balwant Sankaye

Abstract

Tubercular lymphadenopathy is a common entity. Etiologically it can be divided into primary tubercular lymphadenopathy and secondary tubercular lymphadenopathy. Ultrasound can satisfactorily demonstrate the involved lymph nodes. Hence we reviewed the ultrasound findings in all fine needle aspiration cytology proven cases of tubercular lymphadenopathy that presented in the imaging department in the last 12 months. Nine different criteria on Grey Scale ultrasound imaging and three different criteria on Color Doppler ultrasound imaging were used to different tubercular nodes from metastatic lymphadenopathy. Matting, presence of intranodal necrosis-caseation, intranodal calcifications, minimal vascularity and reduced Doppler Pulsatility and Resisitivity Indices were the hallmarks of tubercular lymphadenopathy which enabled correct diagnosis with a sensitivity of 85.25% and a specificity of 98.36 %. Thus ultrasound can satisfactorily differentiate between tubercular and metastatic lymphadenopathy.

Keywords

Lymph node Tuberculosis; Ultrasound; B mode, Colour Doppler, Imaging.

Tüberküler Lenfadenopatide Ultrasound Çalışması

Abstract

Tüberküler lenfadenopati yaygın bir antitedir. Etyolojik olarak primer ve sekonder olmak üzere iki gruba ayrılabilir. Ultrasound ile tutulan lenf nodu demonstre edilebilir. Biz son 12 ay süresince iğne aspirasyon biyopsisi ile tüberküloz lenfadenopati olarak tanınan olguların ultrasound bulgularını gözden geçirdik. Gri skalada 9 farklı kriter, renkli Doppler ultrasoundda ise 3 farklı kriter tüberküler lenfadenopatiyi metastatik lenfadenopatiden ayırt edilmede kullanılmıştır. Intranodal nekroz-kazeifikasyon, intranodal kalsifikasyon, minimal vaskülarite ve azalmış Doppler pulsatilite ve resisitivite endeksleri tüberküloz lenfadenopati tanısı için 85.25% duyarlılık ve 98.36% özgüllük ile doğru tanının konulmasına yardımcı olmaktadır. Bu nedenle ultrasound tüberküloz lenfadenopatiyi metastatic lenfadenopatiden ayırt etmede tatmin edeivi bir yöntemdir.

Keywords

Lenf nodu, tüberküloz, ultrasound B mode, Renkli Doppler, görüntüleme

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• Yazışma Adresi / Address for Correspondence: Dr. Sushil Ghanshyam Kachewar Rural Medical College PIMS (DU), Loni, Maharashtra, INDIA geliş tarihi/received :24.10.2012 kabul tarihi/accepted:30.11.2012