Role of contrast-enhanced ultrasound in assessment of laser ablation of tuberculous cervical lymphadenitis

Objective To assess the efficacy and safety of ultrasonography-guided laser ablation (LA) for tuberculous cervical lymphadenitis. Methods Twenty-three lymph nodes of 16 patients with tuberculous cervical lymphadenitis confirmed by percutaneous biopsy had undergone ultrasonography-guided laser ablation therapy. Contrast-enhanced ultrasound (CEUS) was performed to evaluate the scope and effectiveness during LA. Follow-up CEUS was performed 1, 3, 6, and 12 months after treatment to monitor the volume of lymph nodes and the blood supply. Results Before LA, the mean volume of all lymph nodes was (1.2±0.3) ml (range, 0.5-2.6 ml). Thirteen lymph nodes showed heterogeneous enhancement, and 10 showed homogeneous enhancement in CEUS According to CEUS performed immediately after treatment, 19 lymph nodes showed no enhancement and 4 showed focal enhancement. Supplementary LA was performed in these four lesions until thorough non-enhancement was achieved. No lymph nodes showed enhancement on follow-up CEUS. The mean shrinkage rate of lymph nodes was (90.2±8.1)% at the 12th month. There was no abscess or sinus around lymph nodes. Conclusion CEUS has appreciated value in laser ablation of tuberculous cervical lymphadenitis. It has the advantages of safety and repeatability, and is helpful to evaluate indications, accurately assess the efficacy of laser ablation, and conduct follow-up. Key words: Laser ablation; Contrast-enhanced ultrasound; Tuberculous cervical lymphadenitis