B-mode sonographic criteria for differential diagnosis of cervicofacial lymphadenopathy in cat-scratch disease and toxoplasmosis.

Abstract

Our purpose was to evaluate different sonographic parameters of cervicofacial lymphadenopathy caused by cat-scratch disease (CSD) and toxoplasmosis. By use of high-resolution B-mode sonography a total of 552 lymph nodes in the head and neck were detected between January 1997 and December 2001. There were 71 patients (422 lymph nodes) with CSD and 19 patients (130 lymph nodes) with toxoplasmosis. Sonographic variables, including 20 sonomorphologic features along with age and gender, were analyzed with multivariate logistic regression. Heterogenous lymph nodes were more often found in CSD (p =.003), and nonsharp nodal borders showed a significant association with CSD (p =.0005). Multivariate analysis identified sharpness of borders (p =.0001), S/L ratio (p =.0006), and type of lymphadenopathy (acute, abscessed, chronic) (p =.0006) as most significant for differentiating between CSD and toxoplasmosis. These results provide significant and useful criteria for ultrasonographic differentiation between CSD and toxoplasmosis.