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Eur Radiol (2012) 22:318321 DOI 10.1007/s00330-011-2253-9
PEDIATRIC
Normal mediastinal and hilar lymph nodes in children on multi-detector row chest computed tomography
Pim A. de Jong & Rutger-Jan A. Nievelstein
Received: 29 June 2011 /Revised: 8 August 2011 /Accepted: 11 August 2011 /Published online: 2 September 2011 # The Author(s) 2011. This article is published with open access at Springerlink.com
AbstractObjective To study normal mediastinal and hilar lymph nodes on multi-detector chest computed tomography (CT). Methods A cohort of 120 children aged 117 years underwent emergency CT, including the chest, after high-energy trauma. Axial 5-mm reconstructions were evaluated for lymph nodes at hilar and various mediastinal levels and the short-axis diameters were measured.
Results At least one lymph node was found in 115 (96%) children, with subcarinal (69%), lower paratracheal (64%) and hilar (60%) nodes being most common. Up to 10 years of age most lymph nodes were smaller than or equal to 7 mm. In older children lymph nodes measuring up to 10-mm-short-axis diameter were found. Lymph nodes were rare along the mammary vessels, at lower oesophageal and at prevascular and posterior mediastinal levels in children. Conclusion Mediastinal and hilar lymph nodes are more common than previously thought, probably because of increased detection by modern multi-detector CT. Lymph node location and age have to be taken into account when evaluating lymph nodes in the paediatric chest.
Key Points The size and location of normal lymph nodes is of great diagnostic importance
There is little relevant published information related to pediatric chest computed tomography
We provide normative data concerning mediastinal and hilar lymph nodes in children
These normal values can help identify abnormal lymph nodes in children
Keywords Lymphadenopathy. Pediatric . Chest computed tomography. Mediastinum . Normal measurement
Introduction
Lymphadenopathy can be an important sign of malignant or infectious disease in children. For the diagnosis of abnormally enlarged lymph nodes on chest CT, normal short-axis diameters for various lymph node locations for various ages should be known. For that purpose almost two decades ago Miller et al. studied 213 children aged 1 week to 20 years who did not have mediastinal abnormalities on CT [1]. They did not see any lymph nodes in the mediastinum on the CTs of these children. Around the same time Delacourt...