Sonografische Darstellung mesenterialer Lymphknoten bei gesunden Kindern

Zusammenfassung

Einleitung: Der Nachweis intraabdomineller Lymphknoten wurde lange Zeit als Hinweis auf das Vorliegen entzündlicher oder neoplastischer Erkrankungen aufgefasst. Mittels moderner Ultraschallsysteme gelingt jedoch auch die sonografische Darstellung physiologischer, nicht vergrößerter Lymphknoten im Bauchraum. Wenig ist bisher über den physiologischen intraabdominellen Lymphknotenstatus bei Kindern, insbesondere im Mesenterium, bekannt.

Methodik: 60 gesunde Kinder im Alter von 4 – 17 Jahren wurden transabdominell sonografisch untersucht, wobei Anzahl, Lage und Größe mesenterialer Lymphknoten bestimmt wurden sowie die Darmwanddicke an 5 definierten Stellen gemessen und dokumentiert wurde.

Ergebnisse: Mesenteriale Lymphknoten ≥ 7 mm fanden sich bei 51/60 (85 %) der gesunden Kinder. Bei 31/60 (52 %) der gesunden Kinder fanden sich bis zu 5 Lymphknoten ≥ 7 × 3 mm und bei 20/60 (33 %) mehr als 5 abgrenzbare mesenteriale Lymphknoten ≥ 7 × 3 mm. Die Darmwanddicke lag bei allen gesunden Kindern an allen 5 Lokalisationen unter 2 mm.

Zusammenfasssung: Bei gesunden Kindern lassen sich regelhaft Lymphknoten > 7 mm im Mesenterium sonografisch darstellen.

Abstract

Background: For a long time, the detection of intraabdominal lymph nodes has been considered a sign of inflammatory or neoplastic disease. However, modern ultrasound machines enable the visualisation not only of pathologically enlarged lymph nodes, but normal lymph nodes can also be evaluated. The knowledge of the physiological state of intraabdominal lymph nodes in children is still very limited.

Methods: 60 healthy children between 4 – 17 years of age were examined using transabdominal ultrasound. Number, location and dimension of mesenterial lymph nodes, as well as bowel wall thickness in 5 defined locations were measured and documented.

Results: Mesenteric lymph nodes ≥ 7 mm were found in 51/60 (85 %) of healthy children. In 31/60 (52 %) of the healthy children up to 5 lymph nodes and in 20/60 (33 %) more than 5 mesenteric lymph nodes ≥ 7 × 3 mm were found. The sonographically measured bowel wall thickness was less than 2 mm in all healthy children, at all locations.

Conclusion: In healthy children, mesenterial lymph nodes (> 7 mm) are a normal finding.

Schlüsselwörter

Leitlinien - Normwerte - Lymphadenopathie

Key words

guidelines - normal value - lymphadenopathy

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