MR appearance

Lymph nodes appear of intermediate signal intensity on T1W1 and variable signal intensity on T2W1, although usually greater than the signal intensity of muscle. Lymph nodes enhance to a variable degree following intravenous Gd-DTPA but this does not help to differentiate malignant from hyperplastic lymph nodes. Pelvic lymph nodes greater than 1.0cm in short axis diameter and inguinal nodes greater than 1.5 cm in short axis diameter are considered enlarged (Table 3.1). Lymph nodes in the perirectal, paracervical and pre-sacral spaces are not normally seen, so that their identification on MRI is a good indicator that they are abnormal.

Table 3.1. Upper limit of normal sized pelvic lymph nodes

Location

Inguinal Common iliac Internal iliac Obturator

Pre-sacral, paracervical, perirectal

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