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Lymph Node Staging in the Neck

Daniel T. Boll1,  Andrik J. Aschoff1,  Jonathan S. Lewin1

1University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio

Publication Name: 
Current Protocols in Magnetic Resonance Imaging
Unit Number: 
UNIT A7.7
DOI: 
10.1002/0471142719.mia0707s9
Print Publication Date: 
June, 2003
Online Posting Date: 
August, 2003
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Abstract

This chapter has no abstract.

     
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Table of Contents

  • Unit Introduction
  • Basic Protocol: Imaging of the Lymph Nodes Using MRI
  • Commentary
  • Literature Cited
  • Figures
  • Tables
     
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Materials

Basic Protocol: Imaging of the Lymph Nodes Using MRI

 Materials
  • Normal saline (0.9% NaCl), sterile
  • Gadolinium-based MR contrast agent (e.g., Magnevist, Omniscan, or Prohance)
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Figures

  • Figure A7.7.1
    Mass of the oropharynx on transverse T2-weighted, fat-saturated, MR image (arrowhead). Bilateral normal-sized internal jugular chain lymph nodes (arrows) are visible, without signs of metastatic spread.

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  • Figure A7.7.2
    Imaging of a normal-sized cervical lymph node (arrow) by a transverse T1-weighted SE sequence.

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  • Figure A7.7.3
    Imaging of a normal cervical lymph node (arrow) by a T1-weighted contrast enhanced, fat-saturated SE sequence.

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  • Figure A7.7.4
    Seven anatomic subsites of lymph nodes in the neck. Level I contains the submental and the submandibular nodes. Level II includes the upper deep cervical chain nodes. Level III includes the middle deep cervical chain nodes, and analogous Level IV includes the lower deep cervical chain nodes. Level V comprises the spinal accessory nodes and the transverse cervical chain nodes. Level VI contains the pretracheal, the prelaryngeal, and the paratracheal nodes. In Level VII the upper mediastinal lymph nodes can be found. Figure is based on Harnsberger (1995).

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Literature Cited

Literature Cited
    Cummings, B.J. 1993. Radiation therapy and the treatment of the cervical lymph nodes. In Otolaryngology Head and Neck Surgery, 2nd ed. (B.J. Cummings, and J.M. Fredrickson, eds.) pp. 1626-1648. Mosby, St. Louis.
    Daehnert, W. 1999. Chest Disorders. In Radiology Review Manual, 3rd ed. (W. Daehnert, ed.) pp. 418-420. Williams and Wilkins, Baltimore.
    Harnsberger, H.R. 1995. Lymph node division by levels. In Head and Neck Imaging, 4th ed. (H.R. Harnsberger, ed) pp. 291-294. Mosby, St. Louis.
    Kaji, A.V., Mohuchy, T., and Swartz, J.D. 1997. Imaging of cervical lymphadenopathy. Semin. Ultrasound CT MR 18:220-249.
    Lenz, M., Kersting-Sommerhoff, B., and Gross, M. 1993. Diagnosis and treatment of the N0 neck in carcinomas of the upper aerodigestive tract: Current status of diagnostic procedures. Eur. Arch. Otorhinolaryngol. 250:432-438.
    Lewin, J.S., Nour, S.G., and Duerk, J.L. 2000. Magnetic resonance image-guided biopsy and aspiration. Top. Magn. Reson. Imaging 11:173-183.
    Sakai, O., Curtin, H.D., Romo, L.V., and Som, P.M. 2000. Lymph node pathology: Benign proliferative, lymphoma, and metastatic disease. Radiol.Clin.North Am. 38:979-998.
    Shellock, F.G. and Crues, J.V. 1998. Aneurysm clips: Assessment of magnetic field interaction associated with a 0.2-T extremity MR system. Radiology 208:407-409.
    Shellock, F.G. and Kanal, E. 1998. Aneurysm clips: Evaluation of MR imaging artifacts at 1.5 T. Radiology 209:563-566.
    Shellock, F.G. and Shellock, V.J. 1998. Cranial bone flap fixation clamps: Compatibility at MR imaging. Radiology 207:822-825.
    Som, P.M. 1987. Lymph nodes of the neck. Radiology 165:593-600.
    Som, P.M., Curtin, H.D., and Mancuso, A.A. 2000. Imaging-based nodal classification for evaluation of neck metastatic adenopathy. Am. J. Roentgenol. 174:837-844.
    van den Brekel, M.W. 2000. Lymph node metastases: CT and MRI. Eur. J. Radiol. 33:230-238.
    van den Brekel, M.W., Castelijns, J.A., and Snow, G.B. 1996. Imaging of cervical lymphadenopathy. Neuroimaging Clin. N. Am. 6:417-434.
     
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