Nosheen Ahmad, Asim Shaukat, Shama Aslam, Amna Rehan.
Neck Lymph Nodes Characterization on Diffusion MRI.
Annals Punjab Med Coll Jan ;9(1):9-13.

Objectives: To evaluate the role of Diffusion-Weighted Imaging (DWI) in differentiating the various causes of enlarged neck lymph nodes. Design: Prospective study. Setting: Department of Radiology Allied Hospital, Faisalabad. Period: From July 2013 to December 2013. Patients and Method: Thirty four consecutive patients who presented with clinical suspicion of malignant cervical nodes were included in the study, 19 males (55.9%) and 15 females (44.1%). Their age ranged from 45 to 70 years, mean age 56.62 ±7.54 years referred to the radiology department of Allied hospital Faisalabad, complaining of neck swelling, ultrasound showed cervical nodes and all the patients underwent both MRI (T1W, T2W, DWI, ADC) and  histopathological examination. Results: According to histopathological analysis we divided the examined patients with lymph nodes (n= 34) into 2 categories: malignant lymph nodes 70.6% (n=24) benign lymph nodes 29.4% (n=10). DWI and ADC (apparent diffusion coefficient) values revealed 26 malignant lesions (76.5%), 8 benign (23.5%). The accuracy of the DWMRI was 88.23%. A significant difference between benign and malignant cervical nodes on DWI and on ADC maps is reported. The results obtained were 23 true positive, 3 false positive, 7 true negative and 1 false negative case was identified, yielding a sensitivity of 96%, specificity of 70%, NPV= 87.5% and PPV= 88.5%. The difference between the mean ADC values between benign and malignant lesions was statistically significant (P<0.0001). Conclusion: Diffusion-weighted imaging is a valuable tool in the differentiation of benign and malignant lymph nodes.

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