Objective To determine the perfusion pattern of lymphadenopathy in contrast-enhanced ultrasonography (CEUS) under different reference conditions. Methods The CEUS perfusion patterns of 78 superficial lymph node lesions were compared with their pathology results. Time-intensity curves were used for comparison between benign and malignant lymph nodes. Results Inhomogeneous hyperenhancement was the main perfusion pattern （7/17, 41.2%） in metastatic lymph nodes; compared with homogeneous hyperenhancement （2/4,50.0%） in lymphoma, homogeneous hyperenhancement and isoenhancement （6/52,11.5%） in reactive lymph nodes, and circle enhancement （2/4,50.0%） in tuberculosis. Benign lymph nodes showed different mean value, peak intensity and area under the curve compared with their surrounding arteries (PP>0.05). Malignant lymph nodes showed different mean value and peak intensity compared with their surrounding arteries and tissues (PP
