Characterization of lymphadenopathy by magnetic resonance relaxation times: preliminary results

The purpose of this study was to evaluate the ability of magnetic resonance (MR) to enable characterization of disease within lymph nodes and differentiation between benign and malignant lymph nodes. Ninety-three patients were examined. Normal and malignant lymph nodes were excised from seven patients, and the T1 and T2 relaxation times were analyzed in vitro using spectroscopy. In 86 patients, T1 and T2 relaxation times of the lymph nodes were determined from MR images. Spectroscopic analysis revealed an increase in the T1 and T2 values of nodes involved by neoplasm compared with uninvolved nodes in an individual case. Comparison of measurements from 28 lymph nodes analyzed in vitro using spectroscopy showed an overlap of the T1 and T2 values between normal and malignant lymph nodes. T2 relaxation times and relative spin density values were greater for acute inflammatory nodes than for nodes involved by granulomatous diseases (tuberculosis and sarcoidosis) or nodes replaced by lymphoma or metastasis. Changes in T1 relaxation values were not specific. The measurements of T1 and T2 relaxation times and relative spin density showed an overlap between nonspecific lymphadenopathy, nodes involved by granulomatous diseases, and malignant nodes. Differentiation between these various nonacute types of enlarged lymph nodes could not be achieved using current MR parameters.