Clinical and prognostic significance of emergency MRI findings in neck infections

Heikkinen, Jaakko; Nurminen, Janne; Velhonoja, Jarno; Irjala, Heikki; Happonen, Tatu; Soukka, Tero; Mattila, Kimmo; Hirvonen, Jussi

doi:10.1007/s00330-021-08200-5

Cited by 12 publications

(25 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As expected, extensive infection findings (e.g., parapharyngeal or multi-space abscess) on MRI were associated with a more severe course of the disease (Supplementary Data Table 6). Previously, ME, RPE, and abscess diameter have been shown to predict more severe illnesses in deep neck infection patients with multiple etiologies [11]. Here, ME was a significant predictor of extraoral surgery in patients with odontogenic infections.…”

Section: Discussionmentioning

confidence: 57%

“…and J.He.). MRI criteria for infection and abscess and surgical methods for abscess detection have been previously described [8,11,12]. Both the detection [8] and measurement [11] of an abscess have substantial interobserver reliability.…”

Section: Methodsmentioning

confidence: 99%

“…MRI criteria for infection and abscess and surgical methods for abscess detection have been previously described [8,11,12]. Both the detection [8] and measurement [11] of an abscess have substantial interobserver reliability. For accuracy of abscess detection, the surgical records were reviewed for the presence of pus and were considered the reference standard for abscess diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…Abscess size (maximal diameter) and edema patterns were evaluated to study whether MRI findings predict the surgical approach (intraoral vs. extraoral). On the basis of the fat-suppressed T2-weighted Dixon images, the authors evaluated edema as a high signal in the submandibular space (SMS; inferior to the mylohyoid muscle), sublingual space (SLS; superior to the mylohyoid muscle), visceral space (VS; infrahyoid soft tissue space including the larynx, surrounding strap muscles, and the thyroid; also including edema in the anterior cervical space between the sternocleidomastoid muscle and the carotid space [12]), retropharyngeal space edema (RPE), and mediastinal edema (ME) [11]. These edema patterns have a substantial interobserver agreement [11,12].…”

Section: Methodsmentioning

confidence: 99%

“…In a prospective head-to-head comparison, MRI was also considered superior to CT in the initial evaluation of acute neck infections [9,10]. MRI can also reliably detect abscesses [8] and visualize specific edema patterns associated with more severe illnesses [11,12]. Despite the growing incidence of odontogenic infections and the increasing awareness of the utility of emergency MRI imaging, detailed MRI imaging patterns in serious odontogenic infections and their clinical significance, as well as how accurately MRI can pinpoint the causative tooth, are unknown.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

MRI of odontogenic maxillofacial infections: diagnostic accuracy and reliability

et al. 2022

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

MRI of odontogenic maxillofacial infections: diagnostic accuracy and reliability

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

Diagnostic yield of emergency MRI in non-traumatic headache

et al. 2022

Self Cite

View full text Add to dashboard Cite

Purpose Non-traumatic headache is one of the most common neurological complaints in emergency departments. A relatively low diagnostic yield of magnetic resonance imaging (MRI) among outpatients has been previously reported, but studies of emergency patients are lacking. We sought to determine the diagnostic yield of emergency MRI among outpatients presenting to the emergency department with non-traumatic headache. Methods In this retrospective cohort study, we analyzed emergency MRI referrals in a tertiary hospital for non-traumatic headache over a five-year period. We recorded patient characteristics, relevant clinical information from the referrals, and imaging outcomes. Results In total, 696 emergency patients with non-traumatic headache underwent MRI, most within 24 h of presentation. Significant findings related to headache were found in 136 (20%) patients, and incidental findings in 22% of patients. In a multivariate model, the predisposing factors of the significant findings were age, smoking, nausea, and signs/symptoms of infection. The protective factors were numbness and history of migraine. A predictive clinical score reached only moderate performance. Conclusion Although emergency MRI shows headache-related findings in one in five patients, accurate prediction modeling remains a challenge, even with statistically significant predictors and a large sample size.

show abstract

Odontogenic neck abscesses caused by Streptococcus anginosus group bacteria: Emergency MRI findings

Lääveri,

Heikkinen,

Happonen

et al. 2024

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

View full text Add to dashboard Cite

Clinical and prognostic significance of emergency MRI findings in neck infections

Cited by 12 publications

References 16 publications

MRI of odontogenic maxillofacial infections: diagnostic accuracy and reliability

MRI of odontogenic maxillofacial infections: diagnostic accuracy and reliability

Diagnostic yield of emergency MRI in non-traumatic headache

Odontogenic neck abscesses caused by Streptococcus anginosus group bacteria: Emergency MRI findings

Contact Info

Product

Resources

About