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Research Article

Cancer Research Frontiers. 2016 May; 2(2): 300-310. doi: 10.17980/2016.300

Diffusion-weighted MRI for diagnosis and differential diagnosis of lymphatic malformation in paediatric patients

Alexander Sauer1, Verena Müller2, Thomas Pabst1, Henning Neubauer1 *

1 Department of Diagnostic and Interventional Radiology, 2Department of Paediatrics

University Hospital Wuerzburg, 97080 Wuerzburg, Germany

 

*Corresponding author: Henning Neubauer, MD, MBA. Department of Radiology, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany. Phone: 0049-931-201-34715; Email: neubauer_h@ukw.de, inu75@web.de

Citation:Alexander Sauer, et al. Diffusion-weighted MRI for diagnosis and differential diagnosis of lymphatic malformation in paediatric patients. Cancer Research Frontiers. 2016 May; 2(2): 300-310. doi: 10.17980/2016.300

Copyright: @ 2016 Alexander Sauer, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Competing Interests: The authors declare no competing financial interests.

Received Mar 8, 2016; Revised May 13, 2016; Accepted May 27, 2016. Published June 7, 2016

 

 

Abstract

Background: Diffusion-weighted imaging (DWI) is a useful technique for characterisation and differentiation of various tumour entities. We studied the diagnostic value of DWI in children with lymphatic malformation (LM) and tumours mimicking LM.

Patients and Methods: Twenty consecutive patients (median 8 years, range 36 days to 17 years, females n=6) with histologically proven LM (n=16) or histologically confirmed masses mimicking LM on ultrasonography (n=4) underwent routine MRI at 1.5 Tesla including DWI. We retrospectively analysed imaging features on ultrasonography and MRI with particular emphasis on imaging artefacts secondary to intralesional haemorrhage.

Results: All tumour manifestations were detectable on DWI. Mean apparent diffusion coefficient (ADC, unit: x 10-3 mm2/s) was high with 2.6 ± 0.3 in non-complicated LM (n=12). Partial signal loss, fluid-fluid levels and low signal on the ADC map was observed in the presence of intralesional haemorrhage, which coincided with signal loss in gradient-echo T2*w and with hyperechogenic signal on ultrasonography. Two patients with a large ranula and an infected branchiogenic cyst showed ADC values similar to LM, while DWI suggested a highly cellular mass in another patient eventually confirmed with Hodgkin disease.

Conclusion: DWI is a fast, non-invasive and useful supplement to conventional MRI for the differential diagnosis of complex cystic masses or in cases of tumours of uncertain dignity. Non-complicated lympangioma, haemorrhagic lymphatic malformation and solid tumours each show characteristic signal patterns on DWI.

Keywords:  MRI; diffusion-weighted; lymphatic malformation; differential diagnosis; paediatric

 

 

 

 

 

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