There is no single test clinically available that is independently diagnostic for multiple sclerosis (MS). Currently MS is diagnosed using a combination of clinical evaluation and investigations including magnetic resonance imaging (MRI), interpreted in accordance with diagnostic criteria, to demonstrate the requisite dissemination of lesions in (anatomical) space and time. Lesions comprising inflammatory demyelination in the central nervous system are a core pathological feature of MS. Ultra-high field (e.g. 7 Tesla or 7T) T2*-weighted MRI can demonstrate in vivo a central vein in most of these lesions. This is a histopathologically specific feature which could be exploited to improve diagnostic workup in cases of suspected inflammatory demyelination. Central nervous system white matter not involved in demyelinating lesions is nevertheless affected in MS. The mechanisms inflicting injury to this normal appearing white matter (NAWM) and how they relate to focal lesions are unclear. Damage to NAWM seems important, because it correlates well with disability. Any association between cortical lesions, focal white matter lesions (WML) and diffuse damage to NAWM is difficult to investigate in vivo in MS, principally because MRI is relatively insensitive to cortical lesions. Investigation of such associations may also be confounded by the presence of small focal lesions within the “NAWM” that may remain undetected when using conventional MRI to define NAWM. Advantages inherent to ultra-high field MRI might help mitigate both of these problems.

OBJETIVOS: Avaliar através da técnica de ressonância magnética cardíaca, os parâmetros de função, perfusão e viabilidade miocárdica em pacientes portadores de cardiomiopatia hipertrófica, comparando os grupos com e sem obstrução na via de saída do ventrículo esquerdo. CASUÍSTICA E MÉTODO: Vinte e um pacientes com diagnóstico de cardiomiopatia hipertrófica foram submetidos a estudo por ressonância magnética em aparelho de 1,5 T. Foram realizados estudos de função cardíaca, de espessura segmentar do ventrículo esquerdo; volumes diastólico e sistólico finais do ventrículo esquerdo; fração de ejeção do ventrículo esquerdo; freqüência cardíaca e massa do ventrículo esquerdo. Foi também realizado estudo de perfusão miocárdica em duas fases, a de estresse e repouso bem como de viabilidade miocárdica utilizando a seqüência inversion recovery. RESULTADOS: Os segmentos ventriculares mais comprometidos pela hipertrofia são os da região septal. O grupo de pacientes obstrutivos apresentou distribuição segmentar de espessura miocárdica semelhante ao não obstrutivo, porém com maiores médias que o primeiro grupo. A média da fração de ejeção dos pacientes do grupo obstrutivo foi maior que o grupo não obstrutivo, enquanto que as médias dos volumes sistólico e diastólico final foram discretamente menores no grupo obstrutivo. Houve correlação positiva entre a espessura segmentar do VE e a massa segmentar do realce tardio. A indução de estresse determinou aumento do número de segmentos comprometidos com alteração de perfusão, sendo esta alteração mais evidente no grupo obstrutivo. CONCLUSÃO: Os segmentos ventriculares mais comprometidos pela hipertrofia são os septais com distribuição semelhante nos grupos estudados. A presença de hipertrofia miocárdica está associada a maior extensão de realce tardio. Houve uma tendência a correlação positiva entre as áreas de hipertrofia miocárdica e as áreas de perfusão miocárdica alterada, sendo estes achados mais evidentes no grupo obstrutivo / OBJECTIVES: Evaluate function, perfusion and myocardial viability parameters using cardiac magnetic resonance imaging techniques in patients with hypertrophic cardiomyopathy, comparing groups with or without obstructions in the left ventricular outflow tract. METHODS: Twenty-one patients diagnosed with hypertrophic cardiomyopathy underwent magnetic resonance imaging analysis using a 1.5 T device. The following studies were carried out: cardiac function and segment thickness of the left ventricle; end-diastolic and end-systolic volumes of the left ventricle; left ventricular ejection fraction; cardiac rate and left ventricular mass. A myocardial perfusion test was carried out in two phases, both during medically induced stress and at rest, as well as a myocardial viability test using the inversion recovery sequence method. RESULTS: The ventricular segments most affected by hypertrophy are those of the septal region. The group of obstructed patients had myocardial thickness segment distribution similar to that of the unobstructed group, yet with higher averages than the first group. The average ejection fraction of the obstructed patient group was higher than the unobstructed group, while the averages of the end-systolic and end-diastolic volumes were slightly lower in the obstructed group. A positive correlation was observed between the segment thickness of the left ventricle and the late enhancement segment mass. Stress induction led to an increase in the number of compromised segments with perfusion alterations. These alterations were more evident in the obstructed group. CONCLUSION: The septal ventricular segments were more subject to hypertrophy and had a similar distribution in the groups studied. The presence of myocardial hypertrophy is associated with a greater degree of late enhancement. A positive correlation trend was observed between the areas of myocardial hypertrophy and the areas of altered myocardial perfusion, with these results being more evident in the obstructed group

OBJETIVOS: Avaliar através da técnica de ressonância magnética cardíaca, os parâmetros de função, perfusão e viabilidade miocárdica em pacientes portadores de cardiomiopatia hipertrófica, comparando os grupos com e sem obstrução na via de saída do ventrículo esquerdo. CASUÍSTICA E MÉTODO: Vinte e um pacientes com diagnóstico de cardiomiopatia hipertrófica foram submetidos a estudo por ressonância magnética em aparelho de 1,5 T. Foram realizados estudos de função cardíaca, de espessura segmentar do ventrículo esquerdo; volumes diastólico e sistólico finais do ventrículo esquerdo; fração de ejeção do ventrículo esquerdo; freqüência cardíaca e massa do ventrículo esquerdo. Foi também realizado estudo de perfusão miocárdica em duas fases, a de estresse e repouso bem como de viabilidade miocárdica utilizando a seqüência inversion recovery. RESULTADOS: Os segmentos ventriculares mais comprometidos pela hipertrofia são os da região septal. O grupo de pacientes obstrutivos apresentou distribuição segmentar de espessura miocárdica semelhante ao não obstrutivo, porém com maiores médias que o primeiro grupo. A média da fração de ejeção dos pacientes do grupo obstrutivo foi maior que o grupo não obstrutivo, enquanto que as médias dos volumes sistólico e diastólico final foram discretamente menores no grupo obstrutivo. Houve correlação positiva entre a espessura segmentar do VE e a massa segmentar do realce tardio. A indução de estresse determinou aumento do número de segmentos comprometidos com alteração de perfusão, sendo esta alteração mais evidente no grupo obstrutivo. CONCLUSÃO: Os segmentos ventriculares mais comprometidos pela hipertrofia são os septais com distribuição semelhante nos grupos estudados. A presença de hipertrofia miocárdica está associada a maior extensão de realce tardio. Houve uma tendência a correlação positiva entre as áreas de hipertrofia miocárdica e as áreas de perfusão miocárdica alterada, sendo estes achados mais evidentes no grupo obstrutivo / OBJECTIVES: Evaluate function, perfusion and myocardial viability parameters using cardiac magnetic resonance imaging techniques in patients with hypertrophic cardiomyopathy, comparing groups with or without obstructions in the left ventricular outflow tract. METHODS: Twenty-one patients diagnosed with hypertrophic cardiomyopathy underwent magnetic resonance imaging analysis using a 1.5 T device. The following studies were carried out: cardiac function and segment thickness of the left ventricle; end-diastolic and end-systolic volumes of the left ventricle; left ventricular ejection fraction; cardiac rate and left ventricular mass. A myocardial perfusion test was carried out in two phases, both during medically induced stress and at rest, as well as a myocardial viability test using the inversion recovery sequence method. RESULTS: The ventricular segments most affected by hypertrophy are those of the septal region. The group of obstructed patients had myocardial thickness segment distribution similar to that of the unobstructed group, yet with higher averages than the first group. The average ejection fraction of the obstructed patient group was higher than the unobstructed group, while the averages of the end-systolic and end-diastolic volumes were slightly lower in the obstructed group. A positive correlation was observed between the segment thickness of the left ventricle and the late enhancement segment mass. Stress induction led to an increase in the number of compromised segments with perfusion alterations. These alterations were more evident in the obstructed group. CONCLUSION: The septal ventricular segments were more subject to hypertrophy and had a similar distribution in the groups studied. The presence of myocardial hypertrophy is associated with a greater degree of late enhancement. A positive correlation trend was observed between the areas of myocardial hypertrophy and the areas of altered myocardial perfusion, with these results being more evident in the obstructed group

<p>UVOD: Maligni tumori reproduktivnih organa nalaze se među vodećim uzrocima obolevanja i umiranja od malignih bolesti žena, kako u svetu, tako i u Srbiji. Jedan od najvažnijih puteva &scaron;irenja ovih bolesti je limfogeni, a konvencionalna radiolo&scaron;ka dijagnostika limfnih čvorova kod ovih pacijentkinja je neprecizna. Funkcionalna radiolo&scaron;ka dijagnostika, uključujući i magnentno rezonantnu sekvencu difuzionog kretanja (DWI) i iz nje izvedenu ADC mapu koja omogućava kvantitativnu analizu difuzionih osobina unutar limfnog čvora, daju obećavajuće rezultate u mogućnosti razlikovanja benignih od maligno izmenjenih limfnih čvorova male karlice i ingvinuma kod pacijentkinja obolelih od malignih tumora ženskih polnih organa. CILJ: Cilj studije je 1. utvrđivanje dijagnostičkih mogućnosti magnetnorezonantne sekvence difuzionog kretanja (DWI) u razlikovanju benignih od maligno izmenjenih limfnih čvorova male karlice i ingvinuma kod pacijentkinja obolelih od malignih tumora ženskih polnih organa, poređenjem preoperativno načinjenog magnetnorezonantnog pregleda i postoperativnog patohistolo&scaron;kog nalaza; 2. analiza povezanosti osobina metastatski izmenjenih limfnih čvorova na sekvenci difuzionog kretanja (DWI) i gradusa primarnog tumora, i 3. utvrđivanje uticaja tehničkih karakteristika sekvenci difuzinonog kretanja (DWI) na magnetnorezonantu procenu metastatske infiltracije karličnih i ingvinalnih limfnih čvorova i postoperativnog patohistolo&scaron;kog nalaza. MATERIJAL I METODE: Istraživanje je sprovedeno u periodu od 2013. do 2016.godine, kao prospektivna klinička studija u Centru za radiologiju, na Operativnom odeljenju Zavoda za ginekologiju, Klinike za ginekologiju i aku&scaron;erstvo i u Zavodu za patologiju Kliničkog Centra Vojvodine u Novom Sadu. Studija je obuhvatila 80 pacijentkinja obolelih od malignih tumora vulve, vagine, grlića materice, tela materice i jajnika. Na osnovu lokalizacije malignog tumora sve ispitanice su razvrstane u 5 grupa: grupa A- 3 žene obolele od carcinoma vulve, grupa B- 1 žena obolela od karcinoma vagine, grupa C-32 pacijentkinje obolele od karcinoma grlića materice, grupa D- 30 pacijentkinja obolelih od malignih tumora tela materice i grupa E- 14 žena obolelih od malignih tumora jajnika. Procena stadijuma bolesti definitivno je izvr&scaron;ena posle operacije na osnovu histopatolo&scaron;kog pregleda kompletnog hirur&scaron;kog materijala uključujući i pregled uklonjenih limfnih čvorova na osnovu aktuelne FIGO klasifikacije stadijuma bolesti zasebno za svaku pojedinačnu lokalizaciju malignog tumora. Svim pacijentkinjama je preoperativno načinjen magnetnorezonantni pregled male karlice na uređaju za magnetnu rezonancu 1.5 T General Electric Signa HDx u Centru za radiologiju, Kliničkog centra Vojvodine. Kod istih pacijentkinja naknadno je sprovedeno standardno hirur&scaron;ko lečenje po protokolu hirur&scaron;kog lečenja za dato maligno ginekolo&scaron;ko oboljenje sa karličnom i/ili ingvinalnom limfadenektomijom. Postoperativno je izvr&scaron;ena patohistolo&scaron;ka analiza hirur&scaron;ki uklonjenog materijala i limfnih čvorova razdvojenih po anatomskim grupama u karlici i ingvinalnoj regiji. REZULTATI: Ukupno 2320 limfnih čvorova je mapirano i patohistolo&scaron;ki pregledano kod 80 pacijenata. Metastaze u limfnim čvorovima patohistolo&scaron;ki su verifikovane kod 28 pacijenata (35%). Kod ovih 28 (35%) pacijentkinja, 152 (27,28%) od ukupno 557 limfnih čvorova bilo je metastatski izmenjeno na patohistolo&scaron;kom pregledu. Metastaze u limfnim čvorovima utvrđene su kod 2 pacijentkinje (7,14%) sa karcinomom vulve, 11 (39,28%) sa karcinomom cerviksa, 9 (32,14%) sa tumorima tela materice, te 6 (21,42%) sa tumorima jajnika. Od 28 pacijentkinja kod kojih su utvrđeni pozitivni limfni čvorovi, 14 pacijentkinja (50%) imalo je dobro diferentovan primarni tumor, 8 (28,57%) srednje diferentovan, dok je 6 (21,42%) imalo lo&scaron;e diferentovan primarni tumor. Od ukupno 152 metastatski izmenjena limfna čvora u na&scaron;oj studiji, 8 limfnih čvorova (5,26%) pripadalo je ingvinalnoj grupi od čega 5 (3,289%) povr&scaron;noj ingvinalnoj, a 3 ( 1,97%) dubokoj ingvinalnoj grupi, 8 (5,26%) parametrijalnoj grupi, 48 (31,58%) opturatornoj grupi, 40 (26,31%) spolja&scaron;njoj ilijačnoj grupi, 36 (23,684%) unutra&scaron;njoj ilijačnoj grupi, dok je 12 (7,89%) pripadalo zajedničkoj ilijačnoj grupi karličnih limfnih čvorova. Kraći prečnik limfnog čvora nije pokazao značajnu razliku između metastatskih ( mean &plusmn; SD, 8,3 &plusmn; 5.4 mm, raspon , 4.5-30 mm ) i limfnih čvorova koji nisu bili metastatski izmenjeni ( 6,3 mm &plusmn; 1,5 , 4,5-9,6 mm ; P= 0,191 ). Izmerena ADC vrednost bila je značajno niža kod metastatski izmenjenih limfnih čvorova (mean &plusmn; SD , ADC: 0,8725 x 10-3 mm2/s &plusmn; 0,0125) nego kod limfnih čvorova koji nisu bili metastatski izmenjeni (mean &plusmn; SD, ADC: 1,116 x 10- 3 mm2/s &plusmn; 0,1848; P=0,001). Prosečne vrednosti ADC kod b =800 s/mm2 i b =1200 s/mm2 nisu se značajno razlikovale između metastaski izmenjenih limfnih čvorova (mean &plusmn; SD, ADC: 0,8575 &plusmn; 0,0125 x 10-3 mm2/s, ADC:0,8859 &plusmn; 0,0125 x 10-3 mm2/s) i limfnih čvorova koji nisu metastatski izmenjeni (mean &plusmn; SD, ADC:1,0345 &plusmn; 0,1222 x 10-3 mm2/s, ADC:1,1125 &plusmn; 1638 x 10-3 mm2/s; P =0,657 i P = 0,877). Ako se koristi vrednost ADC od 0,860 x 10- 3 mm2 / s kao kritična vrednost za razlikovanje metastatskih od limfnih čvorova koji nisu metastatski izmenjeni, senzitivnost DWI MR iznosila je 89%, specifičnost 85% i ukupna tačnost 86%. Pozitivna prediktivna vrednost (PPV) DWI MR u detekciji limfnih metastaza u karličnoj i ingvinalnoj regiji iznosila je 30%. Negativna prediktivna vrednost (NPV) testa iznosila je 99%. Pozitivna prediktivna vrednost (PPV) MR zasnovana na kriterijumu ADC vrednosti značajno je veća u odnosu na sve kriterijuma veličine (P &lt; 0,001). Negativna prediktivna vrednost MR zasnovanoj na kriterijumima veličine limfnog čvora i na ACD vrednosti nisu se međusobno statistički značajno razlikovali (P&lt;0,05). Performanse dijagnostičke metode (MR) bile su značajno bolje za minimalnu ADC vrednost od svih kriterijuma baziranih na veličini limfnih čvorova ( P=0.001 za minimalnu ADC vrednost u odnosu na sve druge kriterijume). MRI na osnovu definisanog modela koji kombinuje kriterijum ADC vrednosti sa kriterijumom veličine ima sledeće dijagnostičke performanse za diferencijaciju malignih od benignih limfnih čvorova: senzitivnost od 95%, specifičnost 92%, sveukupna tačnost od 92,5%, pozitivnu prediktivnu vrednost od 46% i negativnu prediktivnu vrednost od 99.6%. ZAKLJUČAK: Kriterijum veličine limfnog čvora nije dovoljno precizan pokazatelj metastatske invazije limfnih čvorova. Sekvenca difuzionog kretanja (DWI) uvek se mora analizirati zajedno sa ADC mapom i visoko rezolutivnim T1 i T2 otežanim magnetnorezonantnim sekvencama. Studijom je dokazan visok stepen povezanosti između preoperativnog određivanja metastaske infiltracije karličnih i ingvinalnih limfnih čvorova malignih tumora ženskih polnih organa primenom sekvence difuzionog kretanja (DWI) i postoperativnog patohistolo&scaron;kog nalaza. Uz graničnu ADC vrednost od 0,860 x 10-3 mm2/ s, senzitivnost MRI DWI u otkrivanju metastatskih limfnih čvorova iznosi 89%, a specifičnost 85%. Kombinacija ADC vrednosti i morfolo&scaron;kih karakteristika limfnih čvorova konvencionalnim magnentno rezonantnim pregledom je najprecizniji prediktor postojanja metastatske infiltracije karličnih i ingvinalnih limfnih čvorova kod pacijentkinja sa malignim tumorima ženskih polnih organa. Tehničke karakteristike sekvenci difuzionog kretanja (DWI) u smislu razlike u visokim b vrednostima ne utiču na magnentno rezonantnu procenu metastatske infiltracije karličnih i ingvinalnih limfnih čvorova kod pacijentkinja sa malignim tumorima ženskih polnih organa. Studijom nije utvrđena statistički značajna razlika između preoperativno utvrđenih ADC vrednosti metastatski izmenjenih limfnih čvorova i stepena histolo&scaron;ke diferencijacije ovih tumora. Sekvenca difuzionog kretanja (DWI) je brza, jednostavna, neinvazivna metoda koja značajno doprinosi dijagnostičkim mogućnostima magnetne rezonance u razlikovanju benignih od malignih limfnih čvorova male karlice i ingvinuma.</p> / <p>INTRODUCTION: Malignant tumors of reproductive organs are among the leading causes of morbidity and mortality in women, both in Serbia and worldwide. Lymphatic spread is one of the most important pathways of tumor dissemination. However, conventional lymph node imaging in these patients is imprecise. Functional imaging, including diffusion-weighted magnetic resonance imaging (DWI MRI) and derived ADC map which allows quantitative analysis of diffusion parameters within a lymph node, provide promising results in discrimination benign from malignant pelvic and inguinal lymph nodes in patients with gynecological malignancies. AIM: Aim of the study was: 1. To assess diagnostic performances of DWI MRI in differentiation between benign and malignant pelvic and inguinal lymph nodes in patients with gynecological malignancies, by comparison of preoperative magnetic resonance and postoperative histopathological findings. 2. To analyze correlation between DWI characteristics of metastatic lymph nodes and grade of the primary tumor, and 3. To evaluate the influence of technical characteristics of DWI sequences on MR assessment of metastatic pelvic and inguinal lymph node and postoperative histopathological findings. MATERIAL and METHODS: The prospective clinical study was conducted in Center for Radiology, Surgery Department of Clinic for Gynecology and Obstetrics and Pathology Department of Clinical Center of Vojvodina from 2013 to 2016. It comprised 80 patients with malignant tumors of vulva, vagina, uterine cervix and body and ovaries. Based on the localization of the tumor, all patients were divided into 5 groups: group A-3 patients with vulvar cancer, group B- 1 patient with vaginal cancer, group C- 32 patients with cervical cancer, group D- 30 patients with uterine body tumors and group E- 14 patients with malignant ovarian tumors. Staging of the disease was performed after surgery based on histopathological examination of complete surgical specimen, including examination of removed lymph nodes, based on current FIGO classification separately for each primary tumor location. Preoperatively, all patients underwent MRI examination (1.5 T General Electric Signa HDx) at Center for Radiology, Clinical Center of Vojvodina. The same patients underwent standard surgical treatment according to the treatment protocol regarding the tumor type and stage, with complete pelvic and/or inguinal lymphadenectomy. Histopathological examination of surgically removed material and lymph nodes separated in pelvic and inguinal anatomic groups was performed after the surgery. RESULTS: The total of 2320 of lymph nodes were mapped and histopathologically examined in 80 patients included in the study. Metastases in lymph nodes were histopathologically confirmed in 28 patients (35%). In these 28(35%) patients, in 152 (27,28%) out of 557 lymph nodes histopathological examination confirmed metastases. Lymph node metastases were confirmed in 2 patients (7.14%) with vulvar cancer, 11 (39.28%) with cervical cancer, 9 (32.14%) with uterine body tumors and 6 (21.42%)patients with ovarian tumors. In 28 patients with positive lymph nodes, 14 patients (50%) had well differentiated primary tumor, 8 (28.57%) moderately differentiated, while 6 (21.42%) patients had poorly differentiated primary tumor. Out of 152 metastatic lymph nodes in our study, 8 lymph nodes (5.26%) were inguinal ( 5 (3.289%) superficial inguinal and 3 ( 1.97%) deep inguinal group), 8 (5.26%) were parametrial, 48 (31. 58%) obturatory, 40 (26.31%) external iliac, 36 (23.684%) internal iliac, while 12 (7. 89%) belonged to common iliac pelvic lymph nodes group. Shorter lymph node axis did not show significant difference between metastatic ( mean &plusmn; SD, 8.3 &plusmn; 5.4 mm, range , 4.5-30 mm ) and benign lymph nodes ( 6.3 mm &plusmn; 1.5 , 4.5-9.6 mm ; P= 0.191 ). Measured ADC values were significantly lower in metastatic (mean &plusmn; SD , ADC: 0.8725 x 10-3 mm2/s &plusmn; 0.0125) than benign lymph nodes (mean &plusmn; SD, ADC: 1.116 x 10-3 mm2/s &plusmn; 0.1848; P=0.001). Mean ADC values at b =800 s/mm2 and b =1200 s/mm2 did not differ significantly between metastatic (mean &plusmn; SD, ADC: 0.8575 &plusmn; 0.0125 x 10-3 mm2/s, ADC:0.8859 &plusmn; 0,0125 x 10-3 mm2/s) and benign lymph nodes (mean &plusmn; SD, ADC:1.0345 &plusmn; 0.1222 x 10-3 mm2/s, ADC:1.1125 &plusmn; 1638 x 10-3 mm2/s; P =0.657 i P = 0.877). If ADC value of 0.860 x 10- 3 mm2 / s is determined as a cut off value for discrimination of benign and malignant lymph nodes, DWI MRI sensitivity was 89%, specificity 85% and overall accuracy was 86%. Positive predictive value (PPV) of DWI MR in detection of pelvic and inguinal lymph node metastases was 30%. Negative predictive value (NPV) of the test was 99%. MRI PPV based on ADC value criteria was significantly higher compared to all size-based criteria (P &lt; 0,001). MRI NPV based on size based and ADC values criteria did not differ significantly (P&lt;0,05). Performances of diagnostic method (MRI) were significantly better for minimal ADC value compared to all lymph node size-based criteria ( P=0.001 for minimal ADC value compared to all other criteria). Combination of ADC value criteria and size-based criteria yields MRI the following diagnostic performances in discrimination between benign and malignant lymph nodes: sensitivity 95%, specificity 92%, overall accuracy 92.5%, positive predictive value 46% and negative predictive value 99.6%. CONCLUSION: Lymph node size is not sufficiently precise criteria for determination of metastatic lymph node involvement. DWI sequence always needs to be evaluated together with ADC map and high resolution T1W and T2W magnetic resonance sequences. The study shows high correlation between preoperative assessment of pelvic and inguinal lymph node metastases from gynecological malignancies using MRI DWI and postoperative histopathological findings. With a cut off ADC value of 0.860 x 10-3 mm2/ s, sensitivity of MRI DWI in metastatic lymph node detection is 89%, while specificity is 85%. Combination of ADC values and morphological lymph nodes characteristics assessed by conventional MRI is the most precise predictor of metastatic pelvic and inguinal lymph node invasion in patients with gynecological malignancies. Technical characteristics of DWI i.e. different high b-values do not influence MR assessment of metastatic pelvic and inguinal lymph node involvement in patients with gynecological malignancies. The study did not confirm statistically significant difference between preoperatively measured ADC valued of metastatic lymph nodes and histological grade of primary tumors. DWI MRI sequence is fast, simple, noninvasive method which aids significantly to MRI diagnostic performances in discrimination between benign and malignant pelvic and inguinal lymph nodes.</p>