Traumatic neuroma and recurrent lymphadenopathy after neck dissection: comparison of radiologic features.
OBJECTIVE
To retrospectively evaluate the ultrasonographic (US), computed tomographic (CT), and magnetic resonance (MR) imaging features that differentiate traumatic neuroma from recurrent lymphadenopathy after neck dissection.


METHODS
Imaging findings of 10 patients with a traumatic neuroma and 17 with recurrent lymphadenopathy were reviewed. US and CT were performed in all patients; MR imaging was performed in 16 patients. Findings analyzed at US included the diameter of the long and short axes, the short-axis-to-long-axis ratio, and the presence of a central hyperechoic area. Findings analyzed at CT were contiguity with common or internal carotid artery, lesion location in correlation with carotid artery, and the presence of a hyperattenuating rim. Findings analyzed at MR imaging included signal intensity on T1- and T2-weighted images, the presence of ring enhancement, and the presence of a hypointense rim on T2-weighted images.


RESULTS
Statistically significant differences were found between traumatic neuroma and recurrent lymphadenopathy in the short-axis-to-long-axis ratio (mean, 0.47 vs 0.72; P < .001), the short-axis diameter (mean, 5.7 vs 12.2 mm; P < .001), the presence of a central hyperechoic area (five of 10 patients [50%] vs one of 17 patients [6%]; P < .05), the frequency of contact with carotid artery (two of 10 patients [20%] vs 13 of 17 patients [76%]; P < .01), and the presence of a hypointense rim on T2-weighted MR images (three of six patients [50%] vs zero of 10 patients [0%]; P < .05). Findings in other parameters were not statistically significant.


CONCLUSIONS
Several imaging findings can differentiate traumatic neuroma from recurrent lymphadenopathy after neck dissection.
Yabuuchi
Hidetake
H
Department of Radiology, National Kyushu Cancer Center, Fukuoka, Japan. yabuuchi@radiol.med.kyushu-u.ac.jp
Kuroiwa
Toshiro
T
Fukuya
Tatsuro
T
Tomita
Kichinobu
K
Hachitanda
Yoichi
Y
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009463:Neuroma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography