Janne Nurminen1, Jarno Velhonoja2, Jaakko Heikkinen1, Tatu Happonen1, Mikko Nyman1, Heikki Irjala2, Tero Soukka3, Kimmo Mattila1,4, Jussi Hirvonen1,4. 1. Department of Radiology, Turku University Hospital, Turku, Finland. 2. Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland. 3. Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland. 4. Department of Radiology, University of Turku, Turku, Finland.
Abstract
BACKGROUND: Computed tomography (CT) has traditionally been the first-line imaging method in neck emergencies such as deep neck infections. Due to superior soft-tissue contrast, magnetic resonance imaging (MRI) may be an alternative to CT, also in emergency situations. PURPOSE: To characterize the use of routine MRI in neck emergencies, with an emphasis on clinical feasibility and diagnostic accuracy in cases of neck infection. MATERIAL AND METHODS: We conducted a retrospective cohort study of all primary neck MRI scans performed using a 3-T MRI device during a five-year follow-up period in a tertiary emergency radiology department. Imaging data were compared with final clinical diagnosis and surgical findings as reference standards. RESULTS: The search identified 461 primary neck MRI scans, of which 334 (72%) were performed on the basis of clinical suspicion of infection. Radiological evidence of infection was observed in 95% of these scans, and at least one abscess was detected in 229 cases (72% of confirmed infection). MRI had an overall technical success rate of 95% and had high positive predictive value for both infection (0.98) and detection of abscess (0.95). CONCLUSION: We found that emergency neck MRI can be successfully performed on most patients, and that MRI detects neck infection with a high accuracy. These results suggest that MRI may be an alternative to CT as the first or only imaging modality in neck emergencies.
BACKGROUND: Computed tomography (CT) has traditionally been the first-line imaging method in neck emergencies such as deep neck infections. Due to superior soft-tissue contrast, magnetic resonance imaging (MRI) may be an alternative to CT, also in emergency situations. PURPOSE: To characterize the use of routine MRI in neck emergencies, with an emphasis on clinical feasibility and diagnostic accuracy in cases of neck infection. MATERIAL AND METHODS: We conducted a retrospective cohort study of all primary neck MRI scans performed using a 3-T MRI device during a five-year follow-up period in a tertiary emergency radiology department. Imaging data were compared with final clinical diagnosis and surgical findings as reference standards. RESULTS: The search identified 461 primary neck MRI scans, of which 334 (72%) were performed on the basis of clinical suspicion of infection. Radiological evidence of infection was observed in 95% of these scans, and at least one abscess was detected in 229 cases (72% of confirmed infection). MRI had an overall technical success rate of 95% and had high positive predictive value for both infection (0.98) and detection of abscess (0.95). CONCLUSION: We found that emergency neck MRI can be successfully performed on most patients, and that MRI detects neck infection with a high accuracy. These results suggest that MRI may be an alternative to CT as the first or only imaging modality in neck emergencies.
Entities:
Keywords:
Magnetic resonance imaging; emergency medicine; infection; neck
Authors: J Heikkinen; J Nurminen; J Velhonoja; H Irjala; T Soukka; T Happonen; M Nyman; K Mattila; J Hirvonen Journal: AJNR Am J Neuroradiol Date: 2021-12-16 Impact factor: 3.825
Authors: Jaakko Heikkinen; Viljami Jokihaka; Janne Nurminen; Ville Jussila; Jarno Velhonoja; Heikki Irjala; Tero Soukka; Tatu Happonen; Jorma Järnstedt; Mikko Nyman; Kimmo Mattila; Jussi Hirvonen Journal: Oral Radiol Date: 2022-08-09 Impact factor: 1.882
Authors: Susanna Esposito; Claudia De Guido; Marco Pappalardo; Serena Laudisio; Giuseppe Meccariello; Gaia Capoferri; Sofia Rahman; Claudio Vicini; Nicola Principi Journal: Children (Basel) Date: 2022-04-26
Authors: Janne Nurminen; Jaakko Heikkinen; Tatu Happonen; Jarno Velhonoja; Heikki Irjala; Tero Soukka; Lauri Ivaska; Kimmo Mattila; Jussi Hirvonen Journal: Pediatr Radiol Date: 2022-02-20
Authors: Eva Villanueva-Fernández; R Casanueva-Muruáis; A Vivanco-Allende; J L Llorente; A Coca-Pelaz Journal: Eur Arch Otorhinolaryngol Date: 2022-06-29 Impact factor: 3.236
Authors: Jaakko Heikkinen; Janne Nurminen; Jarno Velhonoja; Heikki Irjala; Tatu Happonen; Tero Soukka; Kimmo Mattila; Jussi Hirvonen Journal: Eur Radiol Date: 2021-07-30 Impact factor: 5.315