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Published online before print September 9, 2004, 10.1148/radiol.2331030779
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(Radiology 2004;233:523-529.)
© RSNA, 2004

Head and Neck Imaging

Traumatic Neuroma and Recurrent Lymphadenopathy after Neck Dissection: Comparison of Radiologic Features1

Hidetake Yabuuchi, MD, Toshiro Kuroiwa, MD, Tatsuro Fukuya, MD, Kichinobu Tomita, MD and Yoichi Hachitanda, MD

1 From the Departments of Radiology (H.Y., T.K.), Head and Neck Surgery (K.T.), and Pathology (Y.H.), National Kyushu Cancer Center, Fukuoka, Japan; and Department of Radiology, National Oita Hospital, Oita, Japan (T.F.). From the 2002 RSNA scientific assembly. Received May 23, 2003; revision requested August 4; final revision received December 7; accepted February 16, 2004. Address correspondence to H.Y., Department of Radiology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan (e-mail: yabuuchi@radiol.med.kyushuu.ac.jp).

PURPOSE: To retrospectively evaluate the ultrasonographic (US), computed tomographic (CT), and magnetic resonance (MR) imaging features that differentiate traumatic neuroma from recurrent lymphadenopathy after neck dissection.

MATERIALS AND METHODS: Imaging findings of 10 patients with a traumatic neuroma and 17 with recurrent lymphadenopathy were reviewed. US and CT were performed in all patients; MR imaging was performed in 16 patients. Findings analyzed at US included the diameter of the long and short axes, the short-axis–to–long-axis ratio, and the presence of a central hyperechoic area. Findings analyzed at CT were contiguity with common or internal carotid artery, lesion location in correlation with carotid artery, and the presence of a hyperattenuating rim. Findings analyzed at MR imaging included signal intensity on T1- and T2-weighted images, the presence of ring enhancement, and the presence of a hypointense rim on T2-weighted images.

RESULTS: Statistically significant differences were found between traumatic neuroma and recurrent lymphadenopathy in the short-axis–to–long-axis ratio (mean, 0.47 vs 0.72; P < .001), the short-axis diameter (mean, 5.7 vs 12.2 mm; P < .001), the presence of a central hyperechoic area (five of 10 patients [50%] vs one of 17 patients [6%]; P < .05), the frequency of contact with carotid artery (two of 10 patients [20%] vs 13 of 17 patients [76%]; P < .01), and the presence of a hypointense rim on T2-weighted MR images (three of six patients [50%] vs zero of 10 patients [0%]; P < .05). Findings in other parameters were not statistically significant.

CONCLUSION: Several imaging findings can differentiate traumatic neuroma from recurrent lymphadenopathy after neck dissection.

© RSNA, 2004

Index terms: Head and neck neoplasms, CT, 276.1211, 997.129 • Head and neck neoplasms, MR, 276.121411, 276.12143, 997.12941, 997.12972 • Head and neck neoplasms, US, 276.1298, 997.1298 • Lymphatic system, diseases, 276.39, 276.33, 997.33 • Neuroma, 27.45