Detecting lymphadenopathy affected by peri-implantitis using diffusion-weighted magnetic resonance imaging

Purpose: This study aimed to assess peri-implantitis-induced lymphadenopathy on diffusion-weighted imaging (DWI). Methods: This retrospective study was conducted from October 2017 to March 2020 in patients with and without peri-implantitis who underwent magnetic resonance imaging (MRI). Patients in the peri-implantitis group had radiographically confirmed loss of alveolar bone > 2.0 mm and clinical findings such as bleeding on probing, suppuration of tissues surrounding the teeth, probing-pocket depth of > 4 mm, pain on implant function, and clinical implant mobility, whereas those without peri-implantitis had none of the abovementioned clinical findings. The Mann–Whitney U test was used to compare groups, using lymph node (LN) short-axis diameters and apparent diffusion coefficients (ADCs) as the criterion variables and presence or absence of peri-implantitis as the explanatory variable. Receiver operating characteristic (ROC) analysis was done to investigate the effectiveness of LN size and ADC use in detecting peri-implantitis-induced lymphadenopathy. Statistical significance was established at P < 0.05. Results: There were 66 lymph nodes from 12 patients analyzed. The mean LN size and ADC were significantly higher in patients with peri-implantitis than in those without (P < 0.01). ROC curve analysis showed cut-off LN sizes of 4.78 and 4.84 mm and cut-off ADCs of 1.12 and 1.09 for lymphadenopathy affected by peri-implantitis corresponding to levels IB and II, respectively. Conclusions: Cervical lymphadenopathy may be an inflammatory finding associated with peri-implantitis.