Quantitative analysis of cervical lymphadenopathy associated with periodontitis using diffusion-weighted imaging

In this study, we aimed to assess cervical lymphadenopathy associated with periodontitis using diffusion-weighted imaging.

The MRI data of patients examined at our dentistry hospital between April 2017 and March 2018 were retrospectively analyzed. The primary predictor was disease status (presence of periodontitis), and the primary outcomes were the mean size and ADC values of cervical LNs. Age and sex were included as additional variables. Statistical evaluation comprised the Mann-Whitney U test, Spearman's correlation coefficient, and receiver operating characteristic (ROC) curve analysis. A P-value <0.05 was considered statistically significant.

Records from 51 patients (aged 31-77 years) and 194 lymph nodes were reviewed. Short-axis diameter was significantly larger and ADC values were significantly higher in the periodontitis group than in the non-periodontitis group (P<0.001). ROC curve analysis demonstrated good discriminative performance, with AUC values of 0.87-0.93 for short-axis diameter and 0.89-0.92 for ADC. Optimal cutoffs were 4.26 mm (level IB) and 5.50 mm (level IIA) for short-axis diameter, and 0.89 × 10^-3 mm²/s (level IB) and 0.85 × 10^-3 mm²/s (level IIA) for ADC.

Our findings suggest that LN size and ADC values are associated with periodontitis-related lymphadenopathy and may serve as quantitative indicators of inflammatory changes. However, these findings should be interpreted as exploratory, and further prospective studies with external validation are required before clinical implementation.