MRI Sequences in Head & Neck Radiology – State of the Art

Gerlig Widmann; Benjamin Henninger; Christian Kremser; Werner Jaschke

doi:10.1055/s-0043-103280

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2017; 189(05): 413-422
DOI: 10.1055/s-0043-103280

Review

MRI Sequences in Head & Neck Radiology – State of the Art

MRI-Sequenzen in der Kopf-Hals-Radiologie – State of the Art

Authors

Gerlig Widmann
Benjamin Henninger
Christian Kremser
Werner Jaschke

Abstract

Background Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head & neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head & neck MRI and to describe the evidence for which medical question these sequences and techniques are useful.

Method Literature review of state-of-the-art sequences in head & neck MRI.

Results and Conclusion Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Menière’s disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head & neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality.

Key Points:

Understanding of MRI sequences is essential for the correct and reliable interpretation of MRI findings.
MRI protocols have to be carefully selected based on relevant clinical information.
Close collaboration with referring physicians improves the output obtained from the diagnostic possibilities of MRI.

Citation Format

Widmann G, Henninger B, Kremser C et al. MRI Sequences in Head & Neck Radiology – State of the Art. Fortschr Röntgenstr 2017; 189: 413 – 422

Zusammenfassung

Hintergrund Magnetic resonance imaging (MRI) ist ein essentielles bildgebendes Verfahren für die Beurteilung von Kopf-Hals Erkrankungen. Die diagnostische Aussagekraft der MRI ist jedoch stark von der entsprechenden Auswahl und Interpretation der Protokolle und Sequenzen abhängig. Das Ziel dieses Beitrags ist es, State-of-the-art-Sequenzen für die klinische Routine der Kopf-Hals-MRI zusammenzufassen und die Evidenz zu beschreiben, für welche medizinische Fragestellungen diese Sequenzen nützlich sind.

Methode Literaturübersicht von State-of-the-art-Sequences in der Kopf-Hals-MRI.

Ergebnisse und Schlussfolgerung Basis-Sequenzen (T1w, T2w, T1wC+) und Fett-Suppressionstechniken (TIRM/STIR, Dixon, Spectral Fat sat) sind wichtige Bestandteile des diagnostischen Workup von Entzündungen, kongenitalen Läsionen und Tumoren inclusive Staging. Zusätzliche Sequenzen (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) werden verwendet für Pathologien der Hirnnerven, des Labyrinths und zur Beurteilung des endolymphatischen Hydrops bei Menière’s Erkrankung. Gefäß- und Perfusionssequenzen (3D-TOF, TWIST/TRICKS angiography, DCE) kommen bei vaskulären Kontaktsyndrom, Gefäßmalformationen und zur Analyse von mikrovaskulären Parametern der Gewebsperfusion zum Einsatz. Diffusionsgewichtete Bildgebung (EPI-DWI, non-EPI-DWI, RESOLVE) ist hilfreich beim Cholesteatom, Abschätzung von Malignität und der Beurteilung des Behandlungsansprechens und Remissionsstatus bei Kopf-Hals-Malignomen. Das Verständnis der MRI-Sequenzen und die enge Zusammenarbeit mit den zuweisenden Klinikern verbessert die diagnostische Aussagekraft der MR-Bildgebung in der täglichen Routine und ist wegweisend für die weitere Forschung in dieser faszinierenden bildgebenden Modalität.

Kernaussagen:

Das Verständnis von MRI-Sequenzen ist für die korrekte und verlässliche Interpretation von MRI-Befunden essentiell.
MRI Protokolle müssen sorgfältig anhand relevanter klinischer Informationen ausgewählt werden.
Die enge Zusammenarbeit mit den zuweisenden Klinikern verbessert die Ausschöpfung der diagnostischen Möglichkeiten der MR-Bildgebung.

Key words

head/neck - MR imaging - MR angiography - MR diffusion/perfusion

Full Text

References

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