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Abnormal cervical lymph nodes in multiple sclerosis: a preliminary ultrasound study

  • HEAD, NECK AND DENTAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Background

Cervical lymph nodes are the first drainage stations of the brain and therefore play a key role in neuroinflammatory disorders such as multiple sclerosis.

Objective

The aim of this study was to evaluate, by using ultrasound imaging, cervical lymph nodes in patients with multiple sclerosis and to ascertain if such patients have any clinical features to attest their role.

Methods

We enrolled 43 patients affected by relapsing–remitting multiple sclerosis (22 drug free and 21 under treatment with natalizumab or fingolimod), who underwent ultrasound examination. The morphology, diameters and volume of cervical lymph nodes were measured. We evaluated also a control group of 20 healthy volunteers.

Results

Between-group comparisons showed that the mean anteroposterior diameters in the cervical lymph nodes on both sides of the neck were significantly different (χ 2 = 19.5, p < 0.001 for right; χ 2 = 20.0, p < 0.001 for left). Post hoc contrasts showed that the mean anteroposterior diameters were greater both in drug-naive (mean ± SD 0.66 ± 0.20 cm; p < 0.001) and treated patients (0.55 ± 0.24 cm; p < 0.001) compared to healthy individuals (0.36 ± 0.19 cm). Moreover, significant difference (p < 0.001) was shown on comparing the mean volume of the cervical lymph nodes on both sides of the neck in the studied groups. No significant differences emerged between the drug-free and treated patients.

Conclusion

The abnormalities shown by ultrasound in cervical lymph nodes are related to deep ones and independent of the ongoing treatment, suggesting a relationship between lymphatic drainage and disease pathology.

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Author information

Author notes

  1. Francesca Di Giuliano and Maria Albanese contributed equally to this work.

Authors and Affiliations

  1. Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Oxford 81, 00133, Rome, Italy

    Francesca Di Giuliano, Eliseo Picchi, Francesco Garaci, Roberto Floris & Simone Marziali

  2. Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Neuroradiology UOC, Fondazione PTV Policlinico “Tor Vergata”, 00133, Rome, Italy

    Francesca Di Giuliano, Eliseo Picchi, Francesco Garaci, Roberto Floris & Simone Marziali

  3. Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, 00133, Rome, Italy

    Maria Albanese, Francesco Mori, Fabio Buttari, Girolama Alessandra Marfia, Nicola Biagio Mercuri & Diego Centonze

  4. Neurology Unit, Department of Neurosciences, Fondazione PTV Policlinico “Tor Vergata”, University of Rome “Tor Vergata”, Viale Oxford 81, 00133, Rome, Italy

    Maria Albanese, Francesco Mori, Fabio Buttari, Girolama Alessandra Marfia & Nicola Biagio Mercuri

  5. IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, 86077, Pozzilli, IS, Italy

    Diego Centonze

  6. IRCCS Fondazione Santa Lucia, 00143, Rome, Italy

    Nicola Biagio Mercuri

Authors
  1. Francesca Di Giuliano
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  2. Maria Albanese
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Corresponding author

Correspondence to Eliseo Picchi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Funding

This study has not received grant or funding.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Di Giuliano, F., Albanese, M., Picchi, E. et al. Abnormal cervical lymph nodes in multiple sclerosis: a preliminary ultrasound study. Radiol med 123, 202–208 (2018). https://doi.org/10.1007/s11547-017-0829-4

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