Diffusion-weighted MRI in characterization of enlarged cervical lymph nodes

Abstract

Background Diffusion-weighted MRI (DWI) has been shown to enhance the visibility of sub-centimetric lymph nodes (LNs) by suppressing background tissue, thereby facilitating LN identification in comparison to conventional sequences. Aim The purpose of this research is to evaluate the efficacy of DWI and apparent diffusion coefficient in distinguishing among cancerous and benign cervical lymphadenopathy. Patients and methods This prospective research includes 50 cases complaining of cervical LN swelling referred to MR units of Radiodiagnosis and Clinical Oncology department at Tanta University Hospital, with symptoms of enlarged cervical LN. Results The most frequently encountered lesion was lymphoma in 12 (24.00%) cases, followed by metastatic from thyroid carcinoma in 7 (14%) cases and metastasis from cancer parotid in 6 (12%) cases, 5 (10%) cases were diagnosed as metastasis from tongue, metastasis from oropharyngeal mass was found in 4 (8%) cases, 3 cases were diagnosed as TB and acute inflammatory with percentage of (6%) for each one, where there were 2 cases diagnosed with percentage of (4%). This study revealed that DWI is a technique for investigation of tumors histological content of LNs and used for distinguishing among benign and cancerous ones. Conclusion DWI with apparent diffusion coefficient map is a novel and promising method for distinguishing cancerous from noncancerous LN. The addition of DWI to standard MRI gives extra biological and functional information for characterizing cervical LN.