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 AMD 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.
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