MRI in pediatric neck abscesses

Abstract

Imaging plays an important role for therapy planning in patients with suspected neck abscess, which can be life-treatening. The purpose of this retrospective study was to assess the sensitivity and specificity of magnetic resonance imaging (MRI) for neck abscess detection in pediatric patients. Thirty patients (14 m, 16 f; age range 2 mo – 16 yr; mean age 5 yr 6 mo) with suspected deep neck infection were examined on a 1.5 T MRI scanner. The MRI protocol included contrast-enhanced and nonenhanced images. The reference standard was based on surgical findings (26 patients) or on follow-up (four patients). The scans were evaluated independently by two board certified radiologists. Cohen`s kappa was used to assess inter-rater agreement. Diagnostic confidence for the contrast-enhanced images and turbo inversion recovery magnitude images was compared using the Wilcoxon test. Twenty-seven out of thirty patients had abscesses. Sensitivity and specificity for abscesses was 100%. Both readers agreed in 29 of 30 cases (κ = 0,84). Diagnostic confidence was higher when using contrast-enhanced images alone in comparison to turbo inversion recovery magnitude images (p = 0.008). MRI has excellent sensitivity and specificity for head and neck abscesses in pediatric patients. The use of contrast media improves the diagnostic confidence for detecting abscesses.

Keywords

Neck - abscess - infection - MRI - contrast agent