Mediastinal lymph nodes: Assessment with diffusion‐weighted MR imaging
Open Access
- 23 July 2009
- journal article
- research article
- Published by Wiley in Journal of Magnetic Resonance Imaging
- Vol. 30 (2), 292-297
- https://doi.org/10.1002/jmri.21850
Abstract
Purpose To prospectively determine whether the diffusion-weighted magnetic resonance imaging is useful to distinguish between malignant and benign mediastinal lymph nodes. Materials and Methods Thirty-five patients (14 women, 21 men; mean age 52 years) with 91 lymph nodes in the mediastinum detected by computed tomography underwent 1.5 Tesla (T) diffusion-weighted MR imaging before mediastinoscopy (n = 29) and mediastinotomy (n = 6). Diffusion-weighted MR images were acquired with a b factor of 50, and 400 s/mm2 using single-shot echo-planar sequence. Results Of the 35 patients, 18 had diagnosis of malignant tumor. Of the 18 patients with tumor, 8 had nonsmall cell carcinoma, and 10 had small cell carcinoma. Ninety-one mediastinal lymph nodes were detected in the 35 untreated patients: 19 were pathologically diagnosed as metastatic lymph nodes, and 72 lymph nodes were diagnosed as nonmetastatic lymph nodes, including 50 sarcoidosis, 14 reactive lymphoid hyperplasia, and 8 necrotizing granulamatous lymphadenitis. The apparent diffusion coefficient (ADC) was significantly lower in metastatic lymph nodes (1.012 ± 0.025 × 10−3 mm2/s; P < 0.0005) than in benign lymph nodes (1.511 ± 0.075 × 10−3 mm2/s). On the ADC map, malignant nodes showed hyperintense (n = 2, 10.52%), hypointense (n = 14, 73.68%), and mixed intensity (n = 3; 15.78%), whereas benign nodes showed hyperintense (n = 57; 79.16%), hypointense (n = 3; 41.6%), isointense (n = 6; 8.33%), and mixed intensity (n = 6; 8.33%). Conclusion Diffusion-weighted MR with ADC value and signal intensity can be useful in differentiation of malignant and benign mediastinal lymph nodes. J. Magn. Reson. Imaging 2009;30:292–297.This publication has 22 references indexed in Scilit:
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