The role of multidetector computed tomography and MRI in assessment of mesenteric lymphadenopathy

Abstract

Background Computed tomography (CT) and MRI are usually used for mesenteric lymph node (LN) evaluation, based on many criteria such as the morphology, distribution, and enhancement pattern that may give an indication of the underlying pathology. The aim of this work was to evaluate the role of multidetector CT and MRI in detection and characterization of mesenteric lymphadenopathy. Patients and methods This prospective study included a total of 30 patients with mesenteric LNs. Their age ranging from 25 to 75 years old with mean age±SD was 52.5±15.3 years. In total, 16 patients underwent CT examination, 10 patients underwent MRI examination, and four patients underwent both CT and MRI examinations. All patients gave their informed written consent before inclusion in the study. The radiological and histopathological results were collected and then statistically analyzed. Results We found that multidetector computed tomography accuracy in differentiating benign from malignant LNs was 75% with a sensitivity of 71.4% and specificity of 76.9%. Diffusion-weighted-MRI was more accurate (85.7%) in differentiating benign from malignant LNs with a sensitivity of 83.3% and specificity of 87.5%. The mean apparent diffusion coefficient (ADC) value of the malignant mesenteric LNs (0.73±0.18×10−3 mm2/s) was significantly lower than the mean ADC value of benign LNs (1.38±0.28×10−3 mm2/s) and the ADC threshold value to determine whether the lesions were benign or malignant was 0.94×10−3 mm2/s). Conclusion Both CT and MRI have a great role in characterization of mesenteric LN, which helps in differentiation between benign and malignant mesenteric LNs.