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Year :2015
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Month :
September-October
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Volume :
4
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Issue :
4
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Page :
47 - 50
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Differentiating Benign and Malignant Metastatic Cervical Lymph Nodes by Diffusion Weighted MRI Sequence
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Correspondence Address :
Pratap Singh H.Parihar, Varun Goel,
Dr. Pratap Singh H. Parihar,
202, 2nd Floor, Arihant Apartment, Sawangi (Meghe)
Wardha, Maharashtra-442004, India.
E-mail: drphparihar@gmail.com
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Introduction: Introduction: The metastasis to the regional cervical lymph nodes is associated with an increase in nuclear to cytoplasmic ratio leading to reduction in water diffusivity and micro circulation of the node.
Aim: To analyze the potential role of diffusion-weighted imaging to differentiate benign and malignant lymph nodes in oral squamous cell carcinoma.
Materials and Methods: The diffusion-weighted imaging, T1 and T2-weighted MR sequences were performed on biopsy proven squamous cell carcinomas(47 cases) involving oral tongue and/or gingivo-buccal region with cervical lymphadenopathy. The apparent diffusion coefficient [ADC] was measured by using two b factors (500 and 1000 s/mm2).
Results: On diffusion images, 26/47 patients with malignant lymph nodes showed restricted diffusion on DWI with low signal intensity on ADC maps. Whereas all patients with benign nodes showed no restricted diffusion.The ADC was significantly greater in metastatic lymph nodes [0.82×10-3mm2/s, p< 0.01] than in benign lymphadenopathy [1.21×10-3mm2/s]
Conclusion: Diffusion-weighted imaging helps in discriminating malignant from benign lymph nodes resulting from oral cavity squamous cell carcinomas. A minimum threshold value of ADC should be kept in mind to identify malignant lymph nodes after taking an appropriate region of interest.
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