J Korean Radiol Soc.  1999 Oct;41(4):669-676. 10.3348/jkrs.1999.41.4.669.

Magnetization Transfer Ratio in Head and Neck Lymphadenopathy

• Cho SB
• Lee NJ
• Kim MG
• Suh SI
• Choi JO

• KMID: 2103441
• DOI: http://doi.org/10.3348/jkrs.1999.41.4.669

Abstract

PUYPOSE: The purpose of this study was to determine whether the magnetization transfer ratio(MTR) differs between malignant and benign cervical lymphadenopathy. MATERIALS AND METHODS: Magnetization transfer ratios were obtained from 104 lymph nodes of 43 patients. Fifty-five nodes were malignant and 49 were benign. Biopsy or cervical lymph node dissection was performed in 83 nodes, while the remaining 21 were diagnosed clinically or by follow-up imaging studies. Among the 55 malignant nodes, squamous cell carcinomas accounted for 29 cases, lymphomas for 15, undifferentiated carcinomas for four, acute myelogenous leukemia for four, and melanomas for three. The 49 benign nodes comprised 21 cases of reactive hyperplasia, 12 of Kikuchi's disease, nine of acute lymphadenitis, and seven of tuberculous lymphadenitis. All scans were performed using a 1.5T Magnetom Vision(Siemens, Erlangen, Germany) with phased-array or Helmholtz-type neck coil. Scanning was performed with and without magnetization transfer pulse(MT pulse : 11.2 T, 250 Hz band-width, off-set 2.0 KHz) using FLASH 2D sequencing. The region of interest(ROI) for signal intensity(SI) measurements was sampled at the same nodes by keeping the position, shape and size of the ROI constant for the scans before and after the MT pulse was applied. SI measurements were repeated more than three times in each node and the mean value was used to calculate MTR. In this study, however, corrected MTRs(CoMTRs) were used for correction of the effect of background noise produced by magnetic field inhomogeneity. RESULTS: Mean CoMTRs of malignant and benign nodes were 0.33(SD: +/- 0.04) and 0.28(SD: +/- 0.05), respectively. This difference was statistically significant. At CoMTR 0.31, the sensitivity and specificity of malignant nodes were 83% and 75%, respectively. CONCLUSION: A CoMTR of above 0.31 suggests malignant lymphadenopathy. CoMTR is one of the MR criteria which can serve to differentiate between malignant and benign lymphadenopathy.

Keyword

Magnetic resonance(MR), tissue characterization; Magnetic resonance(MR), magnetization transfer contrast; Head and neck neoplasms, MR; Lymphatic system, MR

MeSH Terms

Biopsy
Carcinoma
Carcinoma, Squamous Cell
Follow-Up Studies
Head*
Histiocytic Necrotizing Lymphadenitis
Humans
Hyperplasia
Leukemia, Myeloid, Acute
Lymph Node Excision
Lymph Nodes
Lymphadenitis
Lymphatic Diseases*
Lymphoma
Magnetic Fields
Melanoma
Neck*
Noise
Sensitivity and Specificity
Tuberculosis, Lymph Node