Hye Yeon Choi1, Dae Young Yoon1, Eun Soo Kim2, Sora Baek1, Kyoung Ja Lim1, Young Lan Seo1, Eun Joo Yun1. 1. 1 Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea. 2. 2 Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do, Republic of Korea.
Abstract
BACKGROUND: Preoperative radiological evaluation of the cranial or intracranial extension of malignant head and neck tumors is critical in the planning of curative surgery. PURPOSE: To assess the diagnostic accuracy of computed tomography (CT) combined with magnetic resonance imaging (MRI), compared to CT or MRI alone in diagnosing the direct cranial or intracranial extension of malignant head and neck tumors, using histopathologic results as the reference standard. MATERIAL AND METHODS: CT and MRI images in 41 patients with malignant head and neck tumors abutting the skull were retrospectively reviewed. The images were evaluated for the presence or absence of skull invasion (erosion/destruction of the skull), dural invasion (nodular dural enhancement), and brain invasion (enhancing brain lesion with or without brain swelling/edema). The results of the CT alone, MRI alone, and CT combined with MRI were compared with the histopathologic findings. RESULTS: Of the 41 patients studied, ten had no invasion, eight had skull invasion, 17 had dural invasion, and six had brain invasion by tumor. The sensitivity/specificity/accuracy of CT alone, MRI alone, and CT combined with MRI for diagnosing intracranial extension were 78.0%/100%/94.5%, 85.4%/80.5%/93.9%, and 95.1%/100%/98.8%, respectively. The sensitivity of CT combined with MRI was significantly higher than those of CT alone ( P = 0.0156) and MRI alone ( P = 0.0313). CONCLUSION: CT combined with MRI is a more sensitive tool for the diagnosis of the direct cranial or intracranial extension of malignant head and neck tumors than CT alone and MRI alone.
BACKGROUND: Preoperative radiological evaluation of the cranial or intracranial extension of malignant head and neck tumors is critical in the planning of curative surgery. PURPOSE: To assess the diagnostic accuracy of computed tomography (CT) combined with magnetic resonance imaging (MRI), compared to CT or MRI alone in diagnosing the direct cranial or intracranial extension of malignant head and neck tumors, using histopathologic results as the reference standard. MATERIAL AND METHODS: CT and MRI images in 41 patients with malignant head and neck tumors abutting the skull were retrospectively reviewed. The images were evaluated for the presence or absence of skull invasion (erosion/destruction of the skull), dural invasion (nodular dural enhancement), and brain invasion (enhancing brain lesion with or without brain swelling/edema). The results of the CT alone, MRI alone, and CT combined with MRI were compared with the histopathologic findings. RESULTS: Of the 41 patients studied, ten had no invasion, eight had skull invasion, 17 had dural invasion, and six had brain invasion by tumor. The sensitivity/specificity/accuracy of CT alone, MRI alone, and CT combined with MRI for diagnosing intracranial extension were 78.0%/100%/94.5%, 85.4%/80.5%/93.9%, and 95.1%/100%/98.8%, respectively. The sensitivity of CT combined with MRI was significantly higher than those of CT alone ( P = 0.0156) and MRI alone ( P = 0.0313). CONCLUSION: CT combined with MRI is a more sensitive tool for the diagnosis of the direct cranial or intracranial extension of malignant head and neck tumors than CT alone and MRI alone.
Entities:
Keywords:
CT; MRI; Malignant head and neck tumor; computed tomography; cranial extension; intracranial extension; magnetic resonance imaging