The Role of 3 Tesla Diffusion-Weighted Imaging in the Differential Diagnosis of Benign versus Malignant Cervical Lymph Nodes in Patients with Head and Neck Squamous Cell Carcinoma
Figure 3
MR images of a patient with a biopsy proven oropharyngeal squamous cell carcinoma. (a) Axial native DWI image at b value of 1000 sec/mm2, (b) grey scale ADC map, and (c) contrast-enhanced axial fat-suppressed T1-weighted image showing a left-sided lymph node at level IIa. According to morphological criteria the lymph node oval in shape with a maximum transverse diameter of 6 mm was considered to be noncancerous. At DWI the lymph node showed a mean ADC value of 0.861 × 10−3 mm2/sec and was considered to be pathologically involved. (d) Axial native DWI image at b value of 1000 sec/mm2, (e) grey scale ADC map, and (f) contrast-enhanced axial T2-weighted image showing a right-sided lymph node at level Ib. On the basis of morphological criteria the lymph node, round shaped and 9 mm in size, was considered to be suspicious for metastatic involvement. Concerning DWI, the lymph node showed a mean ADC value of 1.213 × 10−3 mm2/sec and was deemed to be a benign lymph node. At pathological examination level IIa lymph node showed intranodal metastatic deposits and level Ib lymph node was found to be benign.
