Recent advances in MRI of the head and neck, skull base and cranial nerves: new and evolving sequences, analyses and clinical applications

Abstract

MRI is an invaluable diagnostic tool in the investigation and management of patients with pathology of the head and neck. However, numerous technical challenges exist, owing to a combination of fine anatomical detail, complex geometry (that is subject to frequent motion) and susceptibility effects from both endogenous structures and exogenous implants. Over recent years, there have been rapid developments in several aspects of head and neck imaging including higher resolution, isotropic 3D sequences, diffusion-weighted and diffusion-tensor imaging as well as permeability and perfusion imaging. These have led to improvements in anatomic, dynamic and functional imaging. Further developments using contrast-enhanced 3D FLAIR for the delineation of endolymphatic structures and black bone imaging for osseous structures are opening new diagnostic avenues. Furthermore, technical advances in compressed sensing and metal artefact reduction have the capacity to improve imaging speed and quality, respectively. This review explores novel and evolving MRI sequences that can be employed to evaluate diseases of the head and neck, including the skull base.

Exclusively endoscopic endonasal resection of benign orbital tumors: a systematic review and meta‐analysis

“…11,12 These innovations have allowed for improved imaging resolution, higher quality, and thinner slices than have traditionally been afforded. 11,12 In the development of the CHEER staging system, a multidisciplinary panel of expert orbital surgeons indicated an increasing need for advanced imaging (eg, CT angiography) preoperatively with increasing tumor stage. 5 Consistent with this rationale, compared to OCHs, the relative predominance of lower-stage, extraconal tumors among other BOTs within this review may also explain a decreased need for multimodal imaging.…”

“…Although more definitive conclusions regarding this finding are limited by the sample size and the retrospective nature of this review, this finding may reflect the more modern (2008‐2018) body of literature related to other BOTs as compared to OCHs (1999‐2019). Indeed, there have been several advancements in MRI technology including higher field strengths (eg, 3 T) and sequence optimization 11,12 . These innovations have allowed for improved imaging resolution, higher quality, and thinner slices than have traditionally been afforded 11,12 .…”

“…Indeed, there have been several advancements in MRI technology including higher field strengths (eg, 3 T) and sequence optimization 11,12 . These innovations have allowed for improved imaging resolution, higher quality, and thinner slices than have traditionally been afforded 11,12 . In the development of the CHEER staging system, a multidisciplinary panel of expert orbital surgeons indicated an increasing need for advanced imaging (eg, CT angiography) preoperatively with increasing tumor stage 5 .…”

ESTRO ACROP guideline for target volume delineation of skull base tumors

“…MR images should be discussed with the radiologist, since requirements on MRI for RT may differ from routine diagnostic imaging. Contrast-enhanced 3D fast gradient echo T1weighted sequences obtained with a voxel size of 1x1x1 mm, named MPRAGE, 3D FLASH, 3D FGRE, 3D FSPGR, 3D TFE, 3D FFE depending on the manufacturer, should be recommended for their high spatial resolution and accurate characterization of subtle enhancement patterns in the surrounding neurovascular structures, and along the course of the optic nerves [29][30][31]. In addition, they allow reformatting of 3D data for viewing in all three planes without loss of resolution, and are less susceptible to B0 inhomogeneity- [30].…”

Compressed sensing and deep learning reconstruction for women’s pelvic MRI denoising: Utility for improving image quality and examination time in routine clinical practice

“…In addition, T2weighted turbo SE imaging as well as SE imaging can provide more information with the addition of fat suppression pulse for differentiating fat-containing diseases from others. Therefore, women's pelvic MR imaging has been frequently used rather than computed tomography (CT) in routine clinical practice, even though the resultant increase in examination time is considered one of its drawbacks [1,2].…”