Acute neck infections: Prospective comparison between CT and MRI in 47 patients

Purpose: The purpose of this work was to assess the advantages and disadvan tages of MRI versus CT in the initial evaluation of acute infections involv ing the neck. Method: We prospectively evaluated 47 patients with neck infections. All pa tients underwent CT and MRI with contrast of the area of interest using sim ilar slice thickness. Final diagnosis was achieved by percutaneous aspirati on, surgical exploration and drainage, or follow-up after successful antibi otic therapy in all patients, Two radiologists reviewed all imaging studies with special attention to lesion conspicuity, location. extension. bone in volvement, source of infection (odontogenic versus nonodontogenic), and pre sence of gas and/or calcium in the lesions. A 3 point scale was used to gra de these parameters, and statistical comparison was done using paired t tes t. Results: As used in our population, MRI was superior to CT in regard to les ion conspicuity, number of anatomic spaces involved, extension. and source. Additionally, although not statistically significantly, MRI detected a gre ater number of abscess collections. CT was superior to MRI in the detection of intralesional gas and calcium and showed fewer motion artifacts, These advantages of CT were, however, not significantly better than those of MRI. Conclusion: As used in our study, MRI was considered superior to CT in the initial evaluation of neck infections. Our findings suggest that MRI may be used as the first and perhaps the only modality to initially evaluate pati ents with neck infections when clinically feasible.