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.

Abstract

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.

• Authors: Bo-Kyung Je, Min Ja Kim, Sung-Bum Kim, Dae Won Park, Taik-Kun Kim, Nam Joon Lee
• Journal: Journal of computer assisted tomography (J Comput Assist Tomogr) 2005 Nov-Dec Vol. 29 Issue 6 Pg. 889-94 ISSN: 0363-8715 [Print] United States
• PMID: 16272869 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Contrast Media
• Iohexol
• iopromide

Topics

• Adult
• Aged
• Contrast Media (administration & dosage)
• Female
• Humans
• Iohexol (analogs & derivatives)
• Male
• Middle Aged
• Neck (diagnostic imaging)
• Observer Variation
• Radiographic Image Enhancement (methods)
• Time Factors
• Tomography, X-Ray Computed (methods)
• Treatment Outcome
• Tuberculosis, Lymph Node (diagnosis, drug therapy)