Magnetic resonance imaging of metastatic cervical adenopathy

Detecting cervical adenopathy is critical in the management of carcinomas in head and neck. CT scanning remains a very effective modality in defining adenopathy. T1-weighted MRI scans are comparable to CT in detecting lymph nodes. T2-weighted images are less useful as the lymph nodes tend to have long T2 relaxation times similar to the surrounding fat. MR has not proved to be useful in detecting carcinoma in non-enlarged cervical nodes. The morphologic criteria developed for metastatic nodes with CT are appropriate with MRI (size, shape, signal, extracapsular spread). Gadolinium is sometimes useful in defining central necrosis in metastatic squamous cell adenopathy.