[Feasibility of the differential diagnostic imaging of neck lymphomas]

In 51 patients with cervical swellings, pretherapeutic examinations by ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were carried out for the confirmation of exclusion of cervical lymph node metastases. By use of the M/Q ratio and morphological criteria, it is possible with ultrasound to differentiate between relatively enlarged lymph modes and lymph node metastasis with a certainly of > 90%. This was only possible in CT after administration of contrast media and the success rate was lower (72%). Both by use of the M/Q ratio and contrast medium administration, MRI is able to distinguish between lymph node metastases and reactively altered lymph nodes. Differentiation between Hodgkin/non-Hodgkin lymphomas of the neck and reactively enlarged lymph nodes is also possible with the aid of the M/Q ratio. In such cases, sonography and MRI are superior to CT. A certain differentiation between lymph node metastases and Hodgkin/non-Hodgkin lymphomas is only possible in some cases. However, there are indicative criteria for differential diagnosis. A delineation between specific lymph node inflammations and glomus carotid tumors is also possible because of the differing take-up of contrast medium in CT and MRI and via doppler sonographic criteria.