title: Gray-scale sonographic evaluation of cervical lymphadenopathy in cat-scratch disease.
abstract: OBJECTIVE
  The aim of this study was to characterize the gray-scale sonographic findings in the lymph nodes of patients with cat-scratch disease (CSD).
  
  
  METHODS
  We analyzed the sonograms of cervical lymph nodes in 41 patients with proven CSD between January 1997 and October 1999.
  
  
  RESULTS
  A total of 222 involved lymph nodes were detected. Involved nodes were most commonly found in the middle cervical (58%), parotid (37%), upper cervical (37%), and submandibular (17%) regions. We found acute, chronic, or abscessed lymphadenopathy in 63%, 12%, and 24% of patients, respectively. The size of involved lymph nodes ranged from 12 x 4 mm to 35 x 26 mm. The largest involved node had a short axis/long axis ratio of 0.5 or more in 61% of patients. Useful features for the differential diagnosis included markedly decreased echogenicity (100%), normal surrounding tissues (100%), and the presence of an echogenic hilum (76%). Posterior sound enhancement was significantly associated with larger and abscessed lymph nodes.
  
  
  CONCLUSIONS
  Despite the absence of a specific sonographic finding for CSD, gray-scale sonography can provide clues to the diagnosis of CSD in the proper clinical setting.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Killianstrasse 5, D-79106 Freiburg, Germany.
authors.forename: G J
authors.initials: GJ
authors.lastname: Ridder
authors.forename: B
authors.initials: B
authors.lastname: Richter
authors.forename: U
authors.initials: U
authors.lastname: Disko
authors.forename: A
authors.initials: A
authors.lastname: Sander
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002372:Cat-Scratch Disease / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D014463:Ultrasonography