title: Detection and characterization of metastatic cervical adenopathy by MR imaging: comparison of different MR techniques.
abstract: Thirty-five patients scheduled to undergo a neck dissection for squamous cell carcinoma of the head and neck were evaluated preoperatively by magnetic resonance (MR) imaging. Axial and occasionally sagittal and coronal images were obtained. To define the most reliable technique to detect cervical lymph node metastasis, we compared several MR pulse sequences with and without Gd-DTPA administration to histopathologic findings in the neck dissection specimens. T1-weighted spin echo combined with T2-weighted gradient recalled echo (GE) sequences were found to be more useful than any other combination of pulse sequences in localizing lymph nodes. On T2-weighted GE images, lymph nodes were depicted with intermediate to high signal intensity in contrast to low signal muscular and fatty tissue. Gadolinium DTPA enhanced T1-weighted GE images reliably depict central lymph node necrosis, the most specific criterion for lymph node metastasis.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: van den Brekel
authors.forename: J A
authors.initials: JA
authors.lastname: Castelijns
authors.forename: H V
authors.initials: HV
authors.lastname: Stel
authors.forename: J
authors.initials: J
authors.lastname: Valk
authors.forename: G A
authors.initials: GA
authors.lastname: Croll
authors.forename: R P
authors.initials: RP
authors.lastname: Golding
authors.forename: W J
authors.initials: WJ
authors.lastname: Luth
authors.forename: C J
authors.initials: CJ
authors.lastname: Meyer
authors.forename: G B
authors.initials: GB
authors.lastname: Snow
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D009942:Organometallic Compounds; D004369:Pentetic Acid
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA