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Acute neck infections: prospective comparison between CT and MRI in 47 patients
A Muñoz1, M Castillo, M A Melchor
1Section of Neuroradiology, Department of Radiology, Hospital Universitario "12 de Octubre," Madrid, Spain. almugo@teleline.es
Purpose:
The purpose of this work was to assess the advantages and disadvantages of MRI versus CT in the initial evaluation of acute infections involving the neck.
Method:
We prospectively evaluated 47 patients with neck infections. All patients underwent CT and MRI with contrast of the area of interest using similar slice thickness. Final diagnosis was achieved by percutaneous aspiration, surgical exploration and drainage, or follow-up after successful antibiotic therapy in all patients. Two radiologists reviewed all imaging studies with special attention to lesion conspicuity, location, extension, bone involvement, source of infection (odontogenic versus nonodontogenic), and presence of gas and/or calcium in the lesions. A 3 point scale was used to grade these parameters, and statistical comparison was done using paired t test.
Results:
As used in our population, MRI was superior to CT in regard to lesion conspicuity, number of anatomic spaces involved, extension, and source. Additionally, although not statistically significantly, MRI detected a greater number of abscess collections. CT was superior to MRI in the detection of intralesional gas and calcium and showed fewer motion artifacts. These advantages of CT were, however, not significantly better than those of MRI.
Conclusion:
As used in our study, MRI was considered superior to CT in the initial evaluation of neck infections. Our findings suggest that MRI may be used as the first and perhaps the only modality to initially evaluate patients with neck infections when clinically feasible.
Insights
Magnetic resonance imaging (MRI) is superior to computed tomography (CT) for evaluating acute neck infections. MRI offers better visualization of lesions and their spread, making it the preferred initial imaging choice when feasible.
Area of Science:
- Radiology
- Medical Imaging
- Infectious Diseases
Background:
- Acute neck infections require prompt and accurate diagnosis.
- Imaging plays a crucial role in evaluating the extent and source of neck infections.
- Computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used modalities.
Purpose of the Study:
- To compare the advantages and disadvantages of MRI versus CT in the initial evaluation of acute neck infections.
- To determine the optimal imaging modality for diagnosing neck infections.
Main Methods:
- Prospective evaluation of 47 patients with neck infections.
- All patients underwent contrast-enhanced CT and MRI with similar slice thickness.
- Radiologists assessed lesion conspicuity, location, extension, bone involvement, infection source, and presence of gas/calcium using a 3-point scale.
Main Results:
- MRI demonstrated superiority over CT in lesion conspicuity, anatomical space involvement, extension, and infection source identification.
- MRI detected more abscess collections, though not statistically significant.
- CT excelled in detecting intralesional gas and calcium and had fewer motion artifacts, but these advantages were not statistically significant compared to MRI.
Conclusions:
- MRI is considered superior to CT for the initial evaluation of neck infections in this study.
- Findings suggest MRI may serve as the primary or sole initial imaging modality for neck infections when clinically feasible.