List of Contents
MRI of the Neck
In our Institute for Preventive Medicine in Witten the whole-body magnetic resonance tomography provides high resolution anatomical and functional imaging of the organs, tissues and structures of the neck.
With the help of MRI diagnostics, both inflammatory processes and tumorous changes of the neck’s soft tissue, the salivary glands, throat and larynx can be perfectly visualised. The MRI is used as an objective assessment tool for localisation, visualisation and quantification of soft-tissue changes.
This enables us to provide a reliable diagnosis.
In addition, the MRI of the neck is suitable for controlling lymph nodes and for detecting structural changes in the cervical spine.
In the following, we give you an exemplary overview of possible anatomical abnormalities or illnesses of the neck.
Basically, tumors of the neck can be localized with an MRI and their extent/ penetration depth assessed.
In the context of the MRI screening, the earliest stages of benign or malignant forms of larynx tumors can be visualised. The larynx is embedded in the soft tissue of the neck. Structural changes caused by the infiltration of a benign or malignant tumor can be very well displayed by the cross-sectional imaging of the MRI. Likewise, MRi aids in disease monitoring of laryngeal progressive inflammatory processes.
We recommend regular check-ups for smokers because there is an increased risk for throat cancer in this group.
In addition, we can detect the first signs of a variety of salivary gland tumors. Most of them are benign, slow-growing and painless – so they develop unnoticed. If the first precursor is detected in the MRI, your attending physician can initiate appropriate further therapy.
Furthermore, the first mucosal changes caused by a mouth-floor cancer can be visualised in the MRI. The extension in relation to the oral mucosa and the oral floor muscles can be traced using the MRI images. Further diagnostic and therapeutic steps can be immediately discussed with your attending specialist.
When examining the neck, we also look for possible cyst formation. Median and lateral neck cysts (liquid-filled cavities in the middle or at the side) can be detected in the MRI as a smooth limited space requirement without tissue infiltration. Whether or not therapeutic measures become necessary is determined by your treatment of the attending doctor after the diagnosis is completed.
Moreover, we can identify lipomas – benign tumors composed of fatty tissues – with the multilayer technique. They are usually asymptomatic, but can be irritating or pressure-sensitive at the appropriate size. The removal of a lipoma is often only necessary if it is disturbing with regard to esthetics.
Lymph Node Diseases
About one third of all human lymph nodes are located in the neck area. They are part of the lymphatic system and play an important role in the immune response of the body to diseases.
Lymph node changes can be caused by infections (bacterial or viral) or caused by benign or malignant tumors.
The reactive enlargement of the affected cervical lymph nodes due to infections usually decreases after the infection has subsided. If abnormalities of the cervical lymph nodes are detected in the MRI, we recommend further observation and diagnosis by your attending doctor. Especially, chronic inflammatory processes can lead to swelling of the lymph nodes over a longer period of time.
Earliest stages of benign or malignant lymphomas of the cervical lymph nodes can also be found in the context of the MRI screening. Abnormalities of lymph nodes due to malignant Hodgkin’s or Non-Hodgkin’s lymphomas can be visualised as well as changes by metastases of another tumor, for example a throat cancer. (See: MRI of the chest, MRI of the upper abdomen and MRT of the pelvis).
The butterfly-shaped thyroid gland is located below the larynx and in front of the trachea. It produces, among other things, the hormones thyroxine and triiodothyronin, which, for example, control the energy balance of the body cells.
Even the smallest pathological changes of the thyroid gland, which are caused, for example, by iodine, inflammation, autoimmune diseases (the body attacks its own tissues with its immune cells, for example Basedow’s disease), benign or malignant tumors can be detected by MRI imaging.
If, for example, the MRI visualises a thyroid enlargement, which can be caused by inflammation, iodine or an over- or under-function of the gland, we recommend further diagnostics at a specialized practice. Likewise, findings like pathological reduction of the gland or an existing side inequality should be diagnosed by a specialist.
In addition, thyroid nodules or the enlargement of the thyroid gland can cause swallowing disorders.
We can also use the MRI to detect cystic anomalies of the thyroid gland and, if necessary, to discuss a puncture or the removal of the cyst with an endocrinologist (hormone specialists).
Node changes in the thyroid tissue occur frequently, but are rarely of malignant nature. Whether a thyroid nodule is benign or malignant can be detected by biopsy (tissue removal) during the MRI examination. With a clear sensitivity and certain specificity, we can often classify the nodes using MRI images. If the imaging indicates a cancer, a biopsy of the nodule can be arranged with the oncologist (cancer specialist).
With regard to the development of thyroid carcinoma, it is particularly important to detect the earliest signs of the tumor and to conduct a rapid therapy. The MRI allows the accurate assessment of the tumor type and the visualisation and localisation of the tumorous tissue inside or outside the thyroid gland.
The MRI of the throat can provide us with information about hidden abscesses that are not visible or palpable. These can, among other things, be caused by tonsillar or thyroid inflammation.
Moreover, the multilayer technique enables us to discover the smallest precursors of a tonsil or throat cancer. This provides us with data for further professionally adapted diagnosis and therapy.
In this chapter we’ve already informed you about the MRI of the benign or malignant larynx tumors. In addition, the multilayer technique offers the possibility of examining the vocal folds and their surrounding musculature. Among other things, the first signs of the so-called “Reinke edema” are visible, which is caused by an abnormal liquid storage in the vocal folds. Untreated, this leads to a very harsh “whiskey voice”.
Furthermore, muscle abnormalities in this area can lead to the impairment of voice formation.
MRI is also a useful tool for the visualisation of possible lateral neck muscle asymmetries, which can lead to wrong postures.
Furthermore, intramuscular abnormalities can be detected at an early stage. For example, tissue changes due to a soft tissue sarcoma (malignant cancerous form of soft tissues) should be mentioned. The treatment of the earliest stages of this cancer is possible with the surgical removal of the tumor tissue.
We can also detect post-traumatic changes in the muscles (scarring, etc.) after injuries or accidents.
The MRI of the jaw joints allows us to display malfunctions and tissue abnormalities and provides us with a high-contrast visualisation of the jaw joints’ soft tissue.
The MRI image can give us information about:
- Injuries of the joints, for example after a (sports) accident
- Joint inflammation
- Condition and position of the disc (cartilage). A displacement of the discus can contribute to cracking and grinding of the jaw joint.
- Cartilage wear
Please read a detailed description in the chapter “MRI of the vessels“.
The sections of the cervical spine can be displayed at different levels thanks to MRI imaging. We pay special attention to possible disc bulges (protrusio) or herniated discs (prolapse). This can cause pressure damage to the spinal cord, which calls for surgery.
We also examine the condition of the vertebrae, nerve cords, spinal canal and surrounding muscles.
The liquid content of the discs is highly differentiated. In addition, the impairment of the nerves by a prolapse or protrusio can be visualised (spinal stenosis, narrowing of the spinal canal).
Moreover, first signs of vertebral tumors or tumors of the nerve fibres or roots are detectable.
Furthermore, changes of the cervical vertebral joints due to wear-induced, non-inflammatory cartilage degeneration (see chapter “Targeted MRI of the joints“) are diagnosed. Possible symptoms: the narrowing of the joint cavity, abnormal bone proliferation, condensed bone underneath the cartilage, bone defects.
Our team of the Institute for Preventive Medicine in Witten will be happy to answer any questions you may have about magnetic resonance imaging of the neck.