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Society for Pediatric Radiology – Poster Archive

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Final ID: Paper #: 068

Comparison of Ultra High Frequency Ultrasound (40 MHz) Transducer to Conventional High Frequency (15 MHz) Transducer in Imaging and Needle Access of Inguinal Lymph Nodes for Lymphatic Intervention

Purpose or Case Report: Inguinal lymph node identification using ultrasound is critical in performing intranodal lymphangiography. We routinely utilize a 15 MHz “hockey stick” linear high resolution ultrasound probe (Philips Epic 7) for identification as well as to gain needle access into the inguinal lymph node. However in children with severe body wall edema and in low weight premature babied identification of lymph nodes can be difficult and sometimes impossible. Higher frequency ultrasound transducers offer the potential for improved identification of lymph nodes in such cases. The aim of this study was to compare imaging finding of high resolution US probe to the traditional 15 mHz probe in patients undergoing lymph node access for lymphangiography.
Methods & Materials: This is a retrospective comparison of ultrasound images obtained with both 15 MHz linear probe as well as high frequency 40 MHz transducer (Visualsonics Vevo) in patients undergoind inguinal lymph node access for lymphatic imaging and intervention procedures between October 2018 and October 2019. Images were compared for resolution, ease of identification of node, lymph node characteristics and intra nodal needle position.
Results: A total of 15 patients (30 lymph nodes) were included in the study from. Age range included 4 days to 5 years. In all 15 patient, 30 lymph nodes were identified using the 40 MHz probe, however only 24 lymph nodes (80%) were identified using the 15 MHz transducer. Out of the 24 lymph nodes identified using the 15 MHz transducer, 4 lymph nodes (13%) had poorly defined architecture that blended with surrounding fat due to previous injection. These 4 nodes (13%) had a clearly identifiable architecture using the 40 MHz transducer.
Conclusions: The 40 MHz transducer has a superior resolution and can be used to easily identify inguinal lymph nodes even in neonates. Intra nodal needle position at least in some cases is better confirmed using the 40 MHz transducer. Finer details of lymph node including intranodal vessels and efferent lymph vessel are clearly seen with 40 MHz transducer and further studies are required to know the importance of visualizing these structures related to lymphatic access.
  • Krishnamurthy, Ganesh  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Escobar, Fernando  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Srinivasan, Abhay  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Smith, Christopher  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Biko, David  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Pinto, Erin  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Dewitt, Aaron  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Dori, Yoav  ( Childrens Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
Session Info:

Scientific Session III-B: Interventional Radiology

Interventional

SPR Scientific Papers

More abstracts on this topic:
Lymphatic Interventions for Plastic Bronchitis and Outcomes in Patients with Congenital Heart Disease

Krishnamurthy Ganesh, Srinivasan Abhay, Smith Christopher, Savla Jill, Biko David, Pinto Erin, Dewitt Aaron, Dori Yoav, Escobar Fernando

Ultrasound Evaluation of Cervical Lymphadenopathy in Children

Mrak Lara, Riedesel Erica, Maxfield Bradley, Gill Kara

More abstracts from these authors:
Lymphatic Interventions for Plastic Bronchitis and Outcomes in Patients with Congenital Heart Disease

Krishnamurthy Ganesh, Srinivasan Abhay, Smith Christopher, Savla Jill, Biko David, Pinto Erin, Dewitt Aaron, Dori Yoav, Escobar Fernando

Mesenteric Dynamic Contrast MR Lymphangiography: Initial Experience and Comparison with Intranodal and Intrahepatic MR Lymphangiography

Biko David, Pinto Erin, Krishnamurthy Ganesh, Escobar Fernando, Dori Yoav, Smith Christopher, Dewitt Aaron, Gillespie Matthew, Rome Jonathan, Glatz Andrew, Rapp Jordan, Otero Hansel, O'byrne Michael

Due to circumstances surrounding the coronavirus pandemic, this final ePoster exhibit was not submitted.
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