Enlarged cervical lymph nodes at helical CT

Radiology. 1994 Jun;191(3):795-8. doi: 10.1148/radiology.191.3.8184067.


Purpose: To evaluate criteria for differentiating malignant versus reactive lymph nodes in the head and neck on the basis of findings at helical computed tomography (CT).

Materials and methods: Helical CT scans were evaluated of 70 consecutive patients (46 men and 24 women, aged 20-78 years [mean, 51 years]) with known head and neck tumors and cervical lymph node enlargement. The ratio of the maximal longitudinal to the maximal axial diameter (L/T) was calculated for nodes larger than 8 mm in diameter based on measurements obtained from coronal, paraxial, and sagittal reconstructions.

Results: At histologic examination, 96 of 164 nodes were malignant. Of these, 94 of 96 nodes had an L/T of less than 2 (sensitivity, 97%; specificity, 97%; accuracy, 97% for malignancy). Minimal diameter was more than 8 mm in 83 of 96 nodes (sensitivity, 87%; specificity, 89%; accuracy, 88% for malignancy). Low-attenuation centers and rim enhancement were seen in 75 of 96 nodes (sensitivity, 78%; specificity, 100%; accuracy, 86% for malignancy).

Conclusion: The L/T at helical CT provide an accurate assessment of reactive versus malignant nodes in the head and neck.

MeSH terms

  • Adult
  • Aged
  • Diagnosis, Differential
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymphatic Metastasis / diagnostic imaging*
  • Male
  • Middle Aged
  • Neck / diagnostic imaging*
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*