MRI Findings in Acute Tonsillar Infections

Area of Science:

• Radiology
• Infectious Diseases
• Otolaryngology

Background:

• Tonsillar infections can involve abscesses ranging from intratonsillar to deep neck spaces.
• Previous literature lacks clarity on the prevalence and precise nature of these abscesses.
• Magnetic resonance (MR) imaging offers high diagnostic accuracy for neck infections.

Purpose of the Study:

• To characterize the spectrum of MR imaging findings in tonsillar infections.
• To determine the prevalence and location of abscesses associated with tonsillar infections.
• To assess the utility of MR imaging in identifying deep neck space extension.

Main Methods:

• Retrospective cohort study of emergency neck MR imaging scans in patients with tonsillar infections.
• Assessment of imaging findings for signs of infection and abscess location.
• Comparison of imaging findings with clinical, surgical, and final diagnoses.

Main Results:

• 132 patients with tonsillar infection were included; 83% had at least one abscess.
• Most abscesses were peritonsillar; no intratonsillar abscesses were identified.
• MR imaging demonstrated parapharyngeal (36%) and retropharyngeal (10%) extension; positive predictive values were 0.98 for abscesses and 0.86 for deep extension.

Conclusions:

• Emergency neck MR imaging accurately delineates the extent and nature of abscess formation in tonsillar infections.
• MR imaging is a valuable tool for characterizing complications of tonsillar infections.
• Findings aid in understanding the spectrum of tonsillar abscesses and their potential for deep extension.