Jaakko Heikkinen1, Viljami Jokihaka1, Janne Nurminen1, Ville Jussila1, Jarno Velhonoja2, Heikki Irjala2, Tero Soukka3, Tatu Happonen1, Jorma Järnstedt4, Mikko Nyman1, Kimmo Mattila1, Jussi Hirvonen5,6. 1. Department of Radiology, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520, 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. Medical Imaging Center, Department of Radiology, Tampere University and Tampere University Hospital, Tampere, Finland. 5. Department of Radiology, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland. jussi.hirvonen@utu.fi. 6. Medical Imaging Center, Department of Radiology, Tampere University and Tampere University Hospital, Tampere, Finland. jussi.hirvonen@utu.fi.
Abstract
OBJECTIVES: To determine the diagnostic accuracy of emergency magnetic resonance imaging (MRI) in odontogenic maxillofacial infections, the clinical and surgical significance of MRI findings, and whether MRI can identify the tooth responsible for the infection. METHODS: A retrospective cohort study reviewed 106 emergency neck MRI scans of patients with neck infections of odontogenic origin. The diagnostic accuracy of MRI in identifying abscesses was studied relative to surgical findings. Correlations were analyzed between various MRI findings and clinical results and outcomes, such as the surgical approach (intraoral vs. extraoral). The ability of MRI findings to predict the causative tooth was assessed in a blinded multi-reader setting. RESULTS: Of the 106 patients with odontogenic infections, 77 (73%) had one or more abscesses. Imaging showed a sensitivity, specificity, and accuracy of 0.95, 0.84, and 0.92, respectively, for MRI diagnosis of an odontogenic abscess. Among the imaging findings, mediastinal edema was the strongest predictor of extraoral surgery. MRI showed bone marrow edema in the majority of patients, and multi-reader assessment showed good reliability. MRI was also able to predict the causative tooth accurately. CONCLUSIONS: Emergency neck MRI can accurately detect odontogenic abscesses and reliably point to the causative tooth. These results can increase the utility and reliance on emergency MRI in clinical decision-making.
OBJECTIVES: To determine the diagnostic accuracy of emergency magnetic resonance imaging (MRI) in odontogenic maxillofacial infections, the clinical and surgical significance of MRI findings, and whether MRI can identify the tooth responsible for the infection. METHODS: A retrospective cohort study reviewed 106 emergency neck MRI scans of patients with neck infections of odontogenic origin. The diagnostic accuracy of MRI in identifying abscesses was studied relative to surgical findings. Correlations were analyzed between various MRI findings and clinical results and outcomes, such as the surgical approach (intraoral vs. extraoral). The ability of MRI findings to predict the causative tooth was assessed in a blinded multi-reader setting. RESULTS: Of the 106 patients with odontogenic infections, 77 (73%) had one or more abscesses. Imaging showed a sensitivity, specificity, and accuracy of 0.95, 0.84, and 0.92, respectively, for MRI diagnosis of an odontogenic abscess. Among the imaging findings, mediastinal edema was the strongest predictor of extraoral surgery. MRI showed bone marrow edema in the majority of patients, and multi-reader assessment showed good reliability. MRI was also able to predict the causative tooth accurately. CONCLUSIONS: Emergency neck MRI can accurately detect odontogenic abscesses and reliably point to the causative tooth. These results can increase the utility and reliance on emergency MRI in clinical decision-making.
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: Janne Nurminen; Jarno Velhonoja; Jaakko Heikkinen; Tatu Happonen; Mikko Nyman; Heikki Irjala; Tero Soukka; Kimmo Mattila; Jussi Hirvonen Journal: Acta Radiol Date: 2020-07-13 Impact factor: 1.990
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