Detailed nodal features of cervical tuberculous lymphadenitis on serial neck computed tomography before and after chemotherapy: focus on the relation between clinical outcomes and computed tomography features.
OBJECTIVE
To investigate the relation between clinical outcomes and nodal features on computed tomography (CT) in cervical tuberculous lymphadenitis (CTBL) before and after antituberculous chemotherapy.


METHODS
Fifty-six patients with CTBL underwent CT before and after a 6- or 12-month course of standard chemotherapy. Three radiologists evaluated the nodal features on serial CT retrospectively, including calcification (no/punctuate/large), necrosis (no/eccentric/central), perinodal infiltrations (no/localized/extensive), and enhancing patterns (no/peripheral/homogeneous). The clinical outcome was defined as "favorable" (n = 33) or "unfavorable" (n = 23) at the completion of chemotherapy.


RESULTS
All the features on the initial CT scan did not show a statistically significant difference between the favorable and unfavorable groups. On the final CT scan, absence of necrosis (P < 0.005), no infiltration (P < 0.005), no enhancement (P < 0.008), and central enhancement (P < 0.014) were more common in the favorable group, whereas large necrosis (P < 0.005), localized and extensive infiltration (P = 0.005, P < 0.005), and peripheral enhancement were more common in the unfavorable group (P < 0.005, P = 0.009).


CONCLUSIONS
Central necrosis, perinodal infiltration, and peripheral rim enhancement on the final CT scan showed differences between the 2 groups. These CT features reflecting inflammation can be useful findings for assessing treatment response.
Je
Bo-Kyung
BK
Department of Radiology, College of Medicine, Korea University, Seoul, South Korea.
Kim
Min Ja
MJ
Kim
Sung-Bum
SB
Park
Dae Won
DW
Kim
Taik-Kun
TK
Lee
Nam Joon
NJ
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000188:drug therapy*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide