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Related Experiment Videos

Enlarged cervical lymph nodes at helical CT

H J Steinkamp1, N Hosten, C Richter

  • 1Department of Radiology, Freie Universitat Berlin, Klinikum Rudolf Virchow/Standort Wedding, Germany.

Radiology
|June 1, 1994
PubMed
Summary

The longitudinal to transverse (L/T) diameter ratio on helical computed tomography (CT) accurately distinguishes malignant from reactive head and neck lymph nodes. This imaging criterion offers high sensitivity and specificity for malignancy assessment.

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Area of Science:

  • Radiology
  • Oncology
  • Head and Neck Surgery

Background:

  • Cervical lymphadenopathy is common in head and neck cancers.
  • Differentiating malignant from reactive lymph nodes is crucial for diagnosis and treatment planning.
  • Helical computed tomography (CT) is a key imaging modality for evaluating head and neck masses.

Purpose of the Study:

  • To determine the efficacy of helical CT criteria in differentiating malignant from reactive lymph nodes in the head and neck.
  • To assess the diagnostic performance of the longitudinal to transverse (L/T) diameter ratio for lymph node malignancy.

Main Methods:

  • Helical CT scans of 70 patients with enlarged cervical lymph nodes were analyzed.
  • The L/T diameter ratio was calculated for lymph nodes >8 mm using multiplanar reconstructions.

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  • Histological examination served as the gold standard for nodal status.

    • Main Results:

    • The L/T ratio < 2 demonstrated high accuracy (97%) in identifying malignant nodes.
    • Minimal diameter > 8 mm showed 88% accuracy for malignancy.
    • Low-attenuation centers and rim enhancement had 86% accuracy for malignancy.

    Conclusions:

    • The L/T diameter ratio derived from helical CT is a reliable and accurate method for distinguishing malignant from reactive cervical lymph nodes.
    • This imaging parameter can aid in the non-invasive assessment of lymph node involvement in head and neck cancer patients.