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AJNR - American Journal of Neuroradiology

Published ahead of print on October 5, 2007
doi: 10.3174/ajnr.A0743

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Differentiation of Benign and Malignant Pathology in the Head and Neck Using 3T Apparent Diffusion Coefficient Values: Early Experience

A. Srinivasan^a, R. Dvorak^a, K. Perni^a, S. Rohrer^a and S.K. Mukherji^a

^a From the Department of Radiology, Division of Neuroradiology, University of Michigan Health System, Ann Arbor, Mich

View larger version (7K): [in this window] [in a new window]   Fig 1. Scatter plot of ADC values in benign and malignant head and neck lesions at 3T strength.

View larger version (52K): [in this window] [in a new window]   Fig 2. A, T2-weighted axial image in a 35-year-old male patient with pathologically proved sinonasal undifferentiated carcinoma reveals a mass lesion in the left ethmoidal region (black arrows) with resultant sphenoidal mucocele (white arrows). B, The mass demonstrates heterogeneous enhancement (black arrows) on the post-gadolinium axial T1 image with no enhancement within the mucocele (white arrows). C, The ADC in the lesion averaged 1.042 x 10–3 mm2/s.

View larger version (57K): [in this window] [in a new window]   Fig 3. Axial T2-weighted (A) and postcontrast T1-weighted (B) images in a 22-year-old female patient demonstrate a T2 hyperintense lesion with intense contrast enhancement within the right masseter (black arrows), which was a biopsy-proven hemangioma. C, The ADC within the lesion measured 1.842 x 10–3 mm2/s.

View larger version (83K): [in this window] [in a new window]   Fig 4. Axial T2-weighted (A) and postcontrast T1-weighted (B) images in a 40-year-old female patient demonstrate a destructive left skull base pathology with heterogenous hyperintensity and cystic areas on T2-weighted images (black arrows) and nonenhancing portions on the postcontrast images (black arrows). This was a biopsy-proven adenosquamous cell carcinoma with an increased ADC value averaging 1.649 x 10–3 mm2/s, probably due to the necrotic areas within the tumor.

View larger version (91K): [in this window] [in a new window]   Fig 5. Axial MR images in a 29-year-old woman reveal a left jugular foramen mass that is hypointense on T2-weighted (A) images and enhances with contrast (B). This was a biopsy-proven meningioma with a decreased ADC value of 0.669 x 10–3 mm2/s, which may be due to hypercellularity within the benign tumor.