The sonographic features of lymph node venous networks and flow patterns in patients with primary chronic venous disease

Gaorui Liu; Jillian Clarke; Yong Liu; Yunwei Zhang; Irwin Mohan

doi:10.1177/02683555241238770

The sonographic features of lymph node venous networks and flow patterns in patients with primary chronic venous disease

Phlebology. 2024 Mar 11:2683555241238770. doi: 10.1177/02683555241238770. Online ahead of print.

Authors

Gaorui Liu^{1

2}, Jillian Clarke², Yong Liu³, Yunwei Zhang⁴, Irwin Mohan⁵

Affiliations

¹ Western Sydney Vascular, Westmead, NSW, Australia.
² Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
³ Department of Ultrasound, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.
⁴ School of Mathematical and Physical Sciences, Macquarie University, Sydney, NSW, Australia.
⁵ Department of Surgery, Westmead Hospital, University of Sydney Westmead Clinical School, Wentworthville, NSW, Australia.

PMID: 38468145
DOI: 10.1177/02683555241238770

Abstract

Background: Our study aims to enhance the understanding of lymph node venous networks (LNVNs) by summarising their anatomical, sonographic features, and reflux patterns.

Method: We examined 241 legs from 141 patients with primary chronic venous disease (CVD) using duplex ultrasound.

Results: The findings indicated variations in the shape, size, vascularity, and echogenicity of LNVN. The superficial inguinal lymph node with reflux appeared slightly larger, exhibiting higher velocities in the hilar artery. Regarding connections, venous flow within LNVN was predominantly drained through the saphenofemoral junction (SFJ), anterior accessory great saphenous vein (AAGSV), and great saphenous vein (GSV). A significant number of LNVNs were observed to be associated with anterolateral thigh tributaries. The study also identified valve cusps within LNVN.

Conclusion: This study revealed a 12% prevalence of primary LNVN. Understanding the anatomical and haemodynamic features of LNVN informs treatment strategies and potentially helps prevent the recurrence of varicose veins.

Keywords: Chronic venous disease; duplex ultrasound; neovascularization; varicose veins; venous reflux.