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Open Access 01-02-2022 | Edema | Head and Neck

Clinical and prognostic significance of emergency MRI findings in neck infections

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

Published in: European Radiology | Issue 2/2022

Abstract

Objectives

Due to its superior soft-tissue contrast and ability to delineate abscesses, MRI has high diagnostic accuracy in neck infections. Whether MRI findings can predict the clinical course in these patients is unknown. The purpose of this study was to determine the clinical and prognostic significance of various MRI findings in emergency patients with acute neck infections.

Materials and methods

We retrospectively reviewed the 3-T MRI findings of 371 patients with acute neck infections from a 5-year period in a single tertiary emergency radiology department. We correlated various MRI findings, including retropharyngeal (RPE) and mediastinal edema (ME) and abscess diameter, to clinical findings and outcomes, such as the need for intensive care unit (ICU) treatment and length of hospital stay (LOS).

Results

A total of 201 out of 371 patients (54%) with neck infections showed evidence of RPE, and 81 out of 314 patients (26%) had ME. Both RPE (OR = 9.5, p < 0.001) and ME (OR = 5.3, p < 0.001) were more prevalent among the patients who required ICU treatment than among those who did not. In a multivariate analysis, C-reactive protein (CRP) levels, RPE, and maximal abscess diameter were independent predictors of the need for ICU treatment, and CRP, ME, and maximal abscess diameter were independent predictors of LOS.

Conclusion

In patients with an acute neck infection that requires emergency imaging, RPE, ME, and abscess diameter, as shown by MRI, are significant predictors of a more severe illness.

Key Points

• Two hundred one out of 371 patients (54%) with neck infection showed evidence of retropharyngeal edema (RPE), and 81 out of 314 patients (26%) had mediastinal edema (ME).

• Maximal abscess diameter, RPE, and C-reactive protein (CRP) were independent predictors of the need for intensive care unit (ICU) treatment, and maximal abscess diameter, ME, and CRP were independent predictors of length of hospital stay.

• Prognostic significance of MRI findings was evident also while controlling for CRP values.

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Title: Clinical and prognostic significance of emergency MRI findings in neck infections
Authors: Jaakko Heikkinen
Janne Nurminen
Jarno Velhonoja
Heikki Irjala
Tatu Happonen
Tero Soukka
Kimmo Mattila
Jussi Hirvonen
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keyword: Edema
Published in: European Radiology / Issue 2/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-08200-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical and prognostic significance of emergency MRI findings in neck infections

Abstract

Objectives

Materials and methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Key Points

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