Ultrasonographic Appearances of Cervical Lymph Nodes in Healthy Turkish Adults Subpopulation: Preliminary Study

Özlem Okumuş1, Merve Dönmez2, Filiz N. Pekiner2, *
1 Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Istanbul Kemerburgaz University, Istanbul, Turkey
2 Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey

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© 2017 Okumuş et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Marmara University, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Maltepe-Istanbul, Turkey; Tel: +90 (212) 231 91 20; Fax: +90 (212) 246 52 47; E-mail:



The aim of the study was to assess whether there was any relation between age, gender and body mass index (BMI) and nodal forms and vascular type in healthy Turkish adults.

Study Design:

Three neck areas in 25 wholesome patients who were aged from 21 to 58 years, were assessed by gray-scale and color doppler ultrasonography. Ultrasonographic examinations were performed using an ALOKA Prosound Alpha 6 (Hitachi Aloka Medical Systems, Tokyo, Japan) and the images were obtained with a 7.2 MHz linear array transducer. Hajek’s categorization of cervical lymph nodes for sonographic analysis was used. The ultrasonographic characteristics like size, shape, short axis/long axis ratio (S/L), hilum were evaluated. Ultrasonographic examinations of upper cervical, submandibular and submental lymph nodes were carried out and recorded.


The mean age of patients was 31.84±12.80 years. The ratios of lymph nodes with avascular pattern were 96% for the upper cervical lymph area, 92% for the submandibular area and 96% for the submental area. The lowest and highest ratios of short to long axis diameter (S/L) were calculated as 0.18 and 0.66 in all areas. Most normal nodes in the study were oval with an S/L ratio of less than 0.5.


Normal cervical lymph nodes are oval, with an unsharp border and an echogenic hilum but no relation between the age, gender and BMI. Also ultrasonography is an applicable imaging modality for the examination of cervical lymph nodes. However, the deficiency in the number of patients might not allow to generalise our findings to the general populations.

Keywords: Cervical, Lymph nodes, Ultrasonography, Normal anatomy.