Because the tongue is superficially located and the initial manifestation of most diseases occurring there is mucosal change, lingual lesionscan be easily accessed and diagnosed without imaging analysis. Some lingual neoplasms, however, may manifest as a submucosal bulge and be located in a deep portion of the tongue, such as its base; their true characteristics and extent may be rec-ognized only on cross-sectional images such as those obtained by CT or MRI. Some uncommon tongue neoplasms may have characteristic radiologic fea-tures, thus permitting quite specific radiologic diagnosis. Lipomas typically manifest at both CT and MR imaging as homogeneous nonenhancing lesions. Relative to subcutaneous fat they are isoattenuating on CT images, and all MR sequences show them as isointense. Due to the paramagnetic properties of melanin, metastases from melanotic melanoma usually demonstrate high signal intensity on T1-weighted MR images and low signal intensity on T2-weighted images. Although the radiologic findings for other submucosal neoplasms are nonspecific, CT and MR imaging can play an important role in the diagnostic work-up of these unusual tumors. Delineation of the extent of the tumor, and recognition and understanding of the spectrum of imaging and the pathologic features of these lesions, often help narrow the differential diagnosis.
Carcinoma, Adenoid Cystic/diagnosis ; Carcinoma, Mucoepidermoid/diagnosis ; Hemangioma/diagnosis ; Human ; Lipoma/diagnosis ; Lymphoma/diagnosis ; Magnetic Resonance Imaging ; Myoepithelioma/diagnosis ; Neurilemmoma/diagnosis ; Tomography, X-Ray Computed ; Tongue Neoplasms/*diagnosis/secondary

OBJECTIVETo assess the values of color Doppler and magnetic resonance imaging (MRI) in the identification of cervical lymph node micrometastasis of tongue cancer.

METHODSTotally 96 cases of tongue cancer with impalpable neck lymph node was examined with color Doppler and MRI within one week before surgery. Chi-square test was used to assess if the presence of regional lymph node micrometastasis, histopathological analysis as a golden standard lymph node micrometastasis.

RESULTSFor the diagnosis of cervical lymph node micrometastasis, color Doppler was significantly better than MRI in sensitivity (72.5% vs 50.0%, P = 0.039) and the accuracy (78.1% vs 64.6%, P = 0.038), but no significant difference in the specificity (82.1% vs 75.0%, P = 0.357), the positive predictive value (74.4% vs 58.8%, P = 0.159) and the negative predictive value (80.7% vs 67.7%, P = 0.108).

CONCLUSIONColor Doppler is better than MRI in the sensitivity and accuracy for the diagnosis of cervical lymph node micrometastasis of tongue cancer.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Female ; Head and Neck Neoplasms ; diagnosis ; secondary ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; pathology ; Neoplasm Micrometastasis ; Tongue Neoplasms ; diagnosis ; pathology ; Ultrasonography, Doppler, Color