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MR Evaluation of Normal Retroperitoneal and Pelvic Lymph Nodes

PURPOSE: To establish guidelines for normal retroperitoneal and pelvic lymph node size at magnetic resonance imaging (MRI) by correlation with computed tomographic (CT) and lymphangiographic (LAG) data. MATERIALS AND METHODS: Twelve patients previously studied with pre- and post-LAG CT to determine...

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Published in:Clinical radiology 2002-03, Vol.57 (3), p.193-200
Main Authors: Grubnic, Sisa, Vinnicombe, Sarah J., Norman, Andrew R., Husband, Janet E.
Format: Article
Language:English
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Summary:PURPOSE: To establish guidelines for normal retroperitoneal and pelvic lymph node size at magnetic resonance imaging (MRI) by correlation with computed tomographic (CT) and lymphangiographic (LAG) data. MATERIALS AND METHODS: Twelve patients previously studied with pre- and post-LAG CT to determine normal pelvic lymph node size [1] were examined with MRI. All were on surveillance for stage I testicular tumour (minimum follow-up 10 years). Three observers recorded blind the site, size and number of nodes in the retroperitoneum and pelvis at 11 sites. The results were validated with previous CT imaging. RESULTS: Eight hundred and fifteen nodes in 12 patients were visible on the MRI initially, and a further 44 nodes were identified after comparison with post-LAG CT. More nodes were seen on MRI than on CT. The 95th centile values for maximum short axis diameter (MSAD) of pelvic lymph nodes were common iliac and obturator 4mm, external and internal iliac 5mm and hypogastric 6mm. In the retroperitoneum the 95th centile MSAD values were retrocrural, high left para-aortic, paracaval and interaortocaval 3mm, post-caval 4mm and low left para-aortic 5mm. CONCLUSION: MRI criteria for normal retroperitoneal and pelvic lymph node size are defined. Adoption of these recommendations may improve the sensitivity of MRI for the detection of nodal metastases. Grubnic, S.et al. (2002). Clinical Radiology57, 193–200.
ISSN:0009-9260
1365-229X
DOI:10.1053/crad.2001.0893