Vascular evaluation of head and neck masses by magnetic resonance imaging

The vascularity of head and neck masses and their relation to major vessels is an important factor in the differential diagnosis and surgical strategy. Magnetic resonance imaging (MRI) can be tailored to enhance vascular flow by making use of two flow phenomena--time of flight and phase. Fifteen patients with head and neck masses were evaluated by flight flow-sensitive MRI sequences. The inflow-sensitive images were superior to standard unenhanced and gadolinium-enhanced spin echo images in the assessment of tumor vascularity. They were also useful in assessing the relationship of the head and neck masses to the adjacent vessels. The limitation of these inflow-sensitive sequences is the inability to differentiate flow from fat or subacute hemorrhage. Inflow-sensitive MRI obviates the need for diagnostic angiography in most head and neck masses.