ANATOMICAL PARAMETERS AND RADIOLOGICAL CHARACTERISTICS RELEVANT TO THE EVALUATION OF CERVICAL LYMPHONODES: A BIBLIOGRAPHIC REVIEW

Abstract

Objective: The aid of imaging methods for the diagnosis of lymph node pathologies has shown great importance in the evaluation and medical management, since not all structures can be evaluated clinically. The present study carried out a review of several articles and books, demonstrating the usefulness and characteristics of the main imaging methods used in the evaluation of cervical lymph nodes.Methodology: This study is a review of specialized literature, in which a consultation for scientific articles selected by searching the SciELO database, PubMed, EBSCO, Elsevier, New England Journal of Medicine, Virtual Health Library and Ministry of Health. The search for articles was carried out in March 2019. The inclusion criteria were: publication in indexed journals and publication period between 1999 and 2019, 18 articles and books, national and international, were selected for review. Results and Discussion: The recent classification for cervical lymph nodes divided palpable lymph nodes into groups, determined by computed tomography (CT) and magnetic resonance imaging (MRI) sections, and is widely used. For its use in ultrasound (USG), a different approach was proposed, firstly locating certain anatomical structures so that they can then be used as references to identify the superficial lymph nodes that are there. Lymph nodes will be evaluated in terms of number, size and shape, among other characteristics, in search of pathological changes. Due to its high availability and the possibility of being combined with puncture or biopsy, USG becomes a significant method in lymph node evaluation. With it, it is possible to differentiate the benign or malignant nature of a lymph node, in addition to assisting in the puncture decision. However, some lymph nodes cannot be seen with this device, such as facial ones, which makes it irrelevant for analysis of deep lymph nodes. Doppler assistance in US is essential, but it is not routine in clinical practice, being important in cases of doubt regarding the gray scale. CT and MRI are important because they are able to show changes with high resolution, in addition to allowing functional information and distinguishing them from other normal structures, such as muscles and salivary glands. As for the metastatic evaluation, there are differences between CT with contrast and MRI as a first-line exam, since the first has greater accessibility and the second has good accuracy for diagnosis.Conclusion: Lymph node characterization by imaging methods is essential. insofar as they allow the differentiation between benign and malignant lymph nodes, helping to confirm the diagnosis and take the best course of action, often avoiding unnecessary procedures.