The Value of MRI in Imaging Malignant Head and Neck Tumours

Magnetic resonance imaging (MRI) plays an important role in pre-treatment assessment of tumours of the head and neck region. Because of its excellent soft tissue contrast it renders pivotal information in staging and serves as a basis for surgery planning or primary chemo- and/or radiotherapy. Primary tumours are best seen on T2WI with fat saturation or contrast-enhanced images. Morphologic criteria used for lymph node imaging depend on size and shape, and thus MRI is limited in differentiation of normal size malignant nodes or hyperplastic benign nodes. Necrosis is a more specific sign of malignancy.

In this review, imaging technique and imaging of tumours in the head and neck region in general and for specific areas are covered with the emphasis on MR imaging features of the primary tumours and their spread including perineural and lymphatic dissemination. Uncooperative or claustrophobic patients, however, should undergo staging by computerized tomography instead of MRI.