Elsevier

Academic Radiology

Volume 15, Issue 5, May 2008, Pages 641-646
Academic Radiology

Original investigation
Comparison Between Malignant and Benign Abdominal Lymph Nodes on Diffusion-weighted Imaging

https://doi.org/10.1016/j.acra.2007.12.023Get rights and content

Rationale and Objectives

The purpose of this study is to review the apparent diffusion coefficient (ADC) values of benign and metastatic abdominal lymph nodes on diffusion-weighted imaging (DWI).

Materials and Methods

Twenty-eight patients with a total of 40 benign (20 patients) and 16 malignant (8 patients) lymph nodes who underwent DWI MRI of the abdomen (b = 0.600) were enrolled in the study. ADC values of the lymph nodes were measured and comparison was made between benign and malignant groups.

Results

Mean ADC value of lymph nodes was 2.38 ± 0.29 and 1.84 ± 0.37 × 10−3 mm2/sec in the benign and malignant groups, respectively. There was a significant statistical difference between the ADC values of benign and malignant lymph nodes (P < .0005).

Conclusion

A wide range of ADC values exist in patients with metastatic abdominal lymph nodes, with a tendency of higher ADC values in benign lymph nodes.

Section snippets

Patients

This study was performed retrospectively and is Health Insurance Portability and Accountability Act–compliant. The institutional review board approved the study and waived the requirement for informed consent for the retrospective patient data review. After a review of medical, radiologic, and pathologic records obtained between September 2004 and January 2007 in our institution, 28 patients with reported abdominal lymph nodes on MRI were included in the study who had their final diagnoses

Results

Twenty patients (13 males, seven females, ages 26–78 years, mean 54) were enrolled in the benign group and eight patients were enrolled in the malignant group (four males, four females, ages 43–79 years, mean 63). A total of 40 benign and 16 malignant lymph nodes were included in the study. Short- and long-axis diameters of the lymph nodes ranged between 8 and 18.3 mm (mean 11.5) and 8.8 and 39 mm (mean 16.8) in the benign group, respectively. The corresponding measurements for malignant lymph

Discussion

Cross-sectional standard imaging techniques such as MRI and CT are not specific for the diagnosis of metastatic tumors in lymph nodes. Increased short-axis diameter raises the suspicion for malignancy. However, smaller size lymph nodes may also harbor malignancy (4). Reticuloendothelial system–specific contrast agents have been used on MRI to determine lymph node metastases, but the contrast agent is costly and not widely available (5). Diffusion-weighted MRI has been shown to provide

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