Neck Abscess
Conditions
Keywords
Computed tomography, Magnetic resonance imaging
Brief summary
The purpose of this prospective study is to compare MRI and DECT in imaging acute neck infection. 50 patients suspected for neck infection will undergo both modalities, which will then be compared in terms of depiction of edema, conspicuity of inflammation, and characterization and number of abscesses. We hypothesize that DECT will have diagnostic performance comparable to that of MRI, and superior to that of traditional single-energy CT. This study will yield important new information about the performance of DECT, a novel and rapid method for emergency imaging.
Detailed description
Deep neck infections present challenges even in modern medicine, due to complex anatomy and potentially lethal complications. True extent of the infection is difficult to assess clinically. Therefore, medical imaging is useful in determining the exact location and extent of disease. In suspected neck infection, computed tomography (CT) has traditionally been the first-line imaging method. However, magnetic resonance imaging (MRI) provides excellent soft-tissue characterization surpassing that of CT in the initial evaluation of neck infections. Previous studies have shown than MRI is superior to CT in terms of lesion conspicuity and number of affected spaces in neck infections. As an alternative to MRI, dual-energy CT (DECT) could offer improved soft tissue sensitivity compared with traditional single-energy CT. DECT refers to CT imaging carried out with two kinds of spectra of x-ray. In this prospective comparative study, we will recruit emergency patients with suspected neck infection. Neck MRI will be completed as part of standard clinical care, and DECT as part of this research study. After study completion, DECT and MRI will be compared by neuroradiologists, both modalities at separate occasions, blinded to the clinical information and diagnosis as well to the result of the other modality. Clinical care will be based on MRI as is usual practise. Surgical findings will be considered gold standard.
Interventions
DIAGNOSTIC_TESTDual-energy CT
Dual-energy CT
DIAGNOSTIC_TESTMRI
MRI
Sponsors
Turku University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Each patient will be scanned with both DECT and MRI.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Suspicion of acute neck infection as deemed by the referring physician
Exclusion criteria
* History of a serious adverse reaction to intravenous iodine- or gadolinium-based contrast agent * Severe kidney dysfunction (eGFR \< 30 mL/min/1.73m2) * Foreign metallic objects incompatible with MRI in the body * Inability to give informed consent, as deemed by study physician * Inability to follow study instructions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diagnostic accuracy | 1 day | Diagnostic accuracy relative to clinical reference standard (clinical diagnosis or surgery) |
Countries
Finland
Contacts
Primary ContactJussi Hirvonen, MD, PhD
Outcome results
None listed