The Role of Diffusion-Weighted Magnetic Resonance Imaging in the Differentiation of Head and Neck Masses.

Lutfi Kanmaz,Erdal Karavas

doi:10.3390/jcm7060130

Abstract

The purpose of this study was to evaluate the value of diffusion-weighted MRI (DW-MRI) in differentiating benign and malignant head and neck masses by comparing their apparent diffusion coefficient (ADC) values. The study included 32 patients with a neck mass >1 cm in diameter who were examined with echo planar DW-MRI. Two different diffusion gradients (b values of b = 0 and b = 1000 s/mm2) were applied. DWI and ADC maps of 32 neck masses in 32 patients were obtained. Mean ADC values of benign and malignant neck lesions were measured and compared statistically. A total of 15 (46.9%) malignant masses and 17 (53.1%) benign masses were determined. Of all the neck masses, the ADC value of cystic masses was the highest and that of lymphomas was the lowest. The mean ADC values of benign and malignant neck masses were 1.57 × 10−3 mm2/s and 0.90 × 10−3 mm2/s, respectively. The difference between mean ADC values of benign and malignant neck masses was significant (p < 0.01). Diffusion-weighted MRI with ADC measurements can be useful in the differential diagnosis of neck masses.

Highlights

Quick and accurate diagnosis directly affects treatment success for patients with a neck mass, which is a common finding in ENT clinics
Diffusion-weighted magnetic resonance imaging (DW-MRI) is a non-contrast enhanced technique that can be obtained during a single breath-hold
The purpose of this study was to evaluate the value of DW-MRI in differentiating benign and malignant head and neck masses by comparing their apparent diffusion coefficient (ADC) values

Summary

Introduction

Quick and accurate diagnosis directly affects treatment success for patients with a neck mass, which is a common finding in ENT clinics. The rapid development of diagnostic imaging technology has provided clinical practice with new facilities for the evaluation of neck masses These new methods are gaining importance with the advantageous factors of cost and ease of use. MRI evaluates the morphology, signal intensity and enhancement pattern of lesions None of these methods can accurately differentiate benign from malignant lesions. Subsequent studies showed that DW-MRI appeared to be helpful in differentiating epidermoid carcinoma and malignant lymphoma, staging neck nodal disease, and distinguishing radiotherapy-induced tissue changes from persistent or recurrent cancer. In these studies, apparent diffusion coefficient (ADC) values of tissues and lesions are calculated using diffusion-weighted images and different values in the differential diagnosis. The technique may be useful in characterizing thyroid nodules and salivary gland neoplasms

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