Role of Perfusion Magnetic Resonance Imaging in Cervical Lymphadenopathy

Abstract

To assess the role of perfusion magnetic resonance (MR) imaging in patients with cervical lymphadenopathy. Dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging was performed on 45 cervical lymph nodes after a bolus injection of gadolinium-DTPA (0.1 mmol/kg body weight). Time signal intensity curve was created and dynamic susceptibility contrast (DSC) percentage of the lymph nodes was calculated. Receiver operating characteristic curve analysis was used to investigate whether DSC percentage could aid in the characterization of cervical lymphadenopathy. The mean (SD) DSC percentage of malignant nodes (44.8% [6.2%]) was significantly different (P = 0.001) from that of benign nodes (28.8% [4.8%]). The mean (SD) DSC percentage of metastatic nodes (48.72% [2.4%]) was significantly different (P = 0.001) than that of lymphoma (37.09% [3.5%]). The DSC percentage threshold value used for differentiating malignant from benign nodes and metastatic from lymphomatous nodes were 34.3% and 43.5%, with areas under the curve of 0.95 and 0.97, respectively. Perfusion MR imaging is a noninvasive promising method that can be used for differentiation of malignant from benign cervical lymph nodes, and it helps in the characterization of malignant cervical lymphadenopathy.