Nasopharyngeal carcinoma MRI: Difference between revisions

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==Overview==
==Overview==
 
Head and neck [[MRI]] may be helpful in the diagnosis of nasopharyngeal carcinoma. It is especially used for the assessment of [[tumor]] invasion in the [[skull]] [[base]], parapharyngeal spcae, [[paranasal sinus]], [[middle ear]] and [[cervical]] [[lymph node]]<nowiki/>s.
There are no MRI findings associated with [disease name].
 
OR
 
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
 
==MRI==
 
There are no MRI findings associated with [disease name].
 
OR
 
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include:
*[Finding 1]
*[Finding 2]
*[Finding 3]
 
OR
 
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include:
*[Complication 1]
*[Complication 2]
*[Complication 3]
 
==Overview==
Head and neck [[MRI]] may be helpful in the diagnosis of nasopharyngeal carcinoma. Findings on MRI suggestive of [[nasopharyngeal carcinoma]] include dural thickening and [[bone marrow]] infiltration.


==MRI==
==MRI==
[[MRI]] may be diagnostic of [[nasopharyngeal carcinoma]]. Findings on MRI scan suggestive of nasopharyngeal carcinoma include:<ref>http://radiopaedia.org/articles/nasopharyngeal-carcinoma</ref>
[[MRI]] may be helpful in the [[diagnosis]] of Nasopharyngeal carcinoma.


* Findings on [[MRI]] scan suggestive of nasopharyngeal carcinoma include:<ref>{{cite book | last = Hermans | first = R | title = Head and neck cancer imaging | publisher = Springer | location = Berlin New York | year = 2012 | isbn = 9783642178689 }}</ref>
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center"
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center"
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:T1
:T1
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Typically isointense to muscle
*Typically [[isointense]] to [[muscle]] signal
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:T1 C+ (Gd)
:T1 C+ (Gd)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Fat saturation in post contrast sequencse
*Fat saturation in post contrast sequences
*Notable [[heterogeneous]] enhancement is typical
*Notable [[heterogeneous]] enhancement is typical
*Perineural extension should be sought
*Perineural extension should be sought
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:T2
:T2
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Isointense to hyperintense to muscle
*Isointense to hyperintense to [[muscle]] signal
*Fat saturation
*Fat saturation
*Fluid in the middle ear can be helpful  
*Fluid in the [[middle ear]] can be helpful  


|}
|}
* The [[Protocol (natural sciences)|protocol]] for routine [[MRI]] of a nasopharyngeal [[mass]] includes:<ref name="Glastonbury2007">{{cite journal|last1=Glastonbury|first1=Christine M.|title=Nasopharyngeal Carcinoma|journal=Topics in Magnetic Resonance Imaging|volume=18|issue=4|year=2007|pages=225–235|issn=0899-3459|doi=10.1097/RMR.0b013e3181572b3a}}</ref><ref name="DubrulleSouillard2007">{{cite journal|last1=Dubrulle|first1=F.|last2=Souillard|first2=R.|last3=Hermans|first3=R.|title=Extension patterns of nasopharyngeal carcinoma|journal=European Radiology|volume=17|issue=10|year=2007|pages=2622–2630|issn=0938-7994|doi=10.1007/s00330-007-0616-z}}</ref><ref name="ChinFatterpekar2003">{{cite journal|last1=Chin|first1=Shy-Chyi|last2=Fatterpekar|first2=Girish|last3=Chen|first3=Cheng-Yu|last4=Som|first4=Peter M.|title=MR Imaging of Diverse Manifestations of Nasopharyngeal Carcinomas|journal=American Journal of Roentgenology|volume=180|issue=6|year=2003|pages=1715–1722|issn=0361-803X|doi=10.2214/ajr.180.6.1801715}}</ref><ref>{{Cite journal
| author = [[Alfred L. Weber]], [[Sharif al-Arayedh]] & [[Asma Rashid]]
| title = Nasopharynx: clinical, pathologic, and radiologic assessment
| journal = [[Neuroimaging clinics of North America]]
| volume = 13
| issue = 3
| pages = 465–483
| year = 2003
| month = August
| pmid = 14631685
}}</ref><ref>{{Cite journal
| author = [[Julian Goh]] & [[Keith Lim]]
| title = Imaging of nasopharyngeal carcinoma
| journal = [[Annals of the Academy of Medicine, Singapore]]
| volume = 38
| issue = 9
| pages = 809–816
| year = 2009
| month = September
| pmid = 19816641
}}</ref>
** Unenhanced T1- weighted [[axial]] and [[sagittal plane]] [[images]] for:
*** Detection of [[skull]] base invasion
** T2-weighted fast spin-echo sequence in [[axial plane]] [[images]] for:
*** Evaluation  of early parapharyngeal [[tumor]] spread
*** Invasion to the [[paranasal sinus]]
*** Effusions of the [[middle ear]]
*** Detection of [[cervical]] [[Lymph node|lymph nodes]].
** Contrast-enhanced T1-weighted [[axial]] and [[coronal plane]]<nowiki/>s [[images]] (with and without fat suppression) for:
** Evaluation of [[tumor]] extension to the perineural and intracranial space. 
* Additional [[MRI]] component:<ref name="NgChan2009">{{cite journal|last1=Ng|first1=Shu-Hang|last2=Chan|first2=Sheng-Chieh|last3=Yen|first3=Tzu-Chen|last4=Chang|first4=Joseph Tung-Chieh|last5=Liao|first5=Chun-Ta|last6=Ko|first6=Sheung-Fat|last7=Wang|first7=Hung-Ming|last8=Wai|first8=Yau-Yau|last9=Wang|first9=Jiun-Jie|last10=Chen|first10=Min-Chi|title=Pretreatment evaluation of distant-site status in patients with nasopharyngeal carcinoma: accuracy of whole-body MRI at 3-Tesla and FDG-PET-CT|journal=European Radiology|volume=19|issue=12|year=2009|pages=2965–2976|issn=0938-7994|doi=10.1007/s00330-009-1504-5}}</ref><ref name="FongBhatia2010">{{cite journal|last1=Fong|first1=Devin|last2=Bhatia|first2=Kunwar S.S.|last3=Yeung|first3=David|last4=King|first4=Ann D.|title=Diagnostic accuracy of diffusion-weighted MR imaging for nasopharyngeal carcinoma, head and neck lymphoma and squamous cell carcinoma at the primary site|journal=Oral Oncology|volume=46|issue=8|year=2010|pages=603–606|issn=13688375|doi=10.1016/j.oraloncology.2010.05.004}}</ref><ref>{{Cite journal
| author = [[Ann D. King]], [[David K. W. Yeung]], [[Anil T. Ahuja]], [[S. F. Leung]], [[Gary M. K. Tse]] & [[Andrew C. van Hasselt]]
| title = In vivo proton MR spectroscopy of primary and nodal nasopharyngeal carcinoma
| journal = [[AJNR. American journal of neuroradiology]]
| volume = 25
| issue = 3
| pages = 484–490
| year = 2004
| month = March
| pmid = 15037477
}}</ref>
** Diffusion-weighted imaging for:
*** Differentiating NPC from [[lymphoma]]
*** Characterizing of [[cervical]] [[lymphadenopathy]]
** [[Magnetic resonance imaging|MRI]] [[spectroscopy]] for:
*** Differentiating of the NPC and [[metastatic]] nodes from normal [[neck]] [[muscle]].


The protocol for routine MRI of a nasopharyngeal mass includes:
[[File:PMC4582819 13014 2015 513 Fig1 HTML (1).png|500px|none|thumb|source:https://openi.nlm.nih.gov/detailedresult?img=PMC4582819_13014_2015_513_Fig1_HTML&query=nasopharyngeal%20carcinoma&it=xg&req=4&npos=27]]
* Unenhanced T1- weighted axial and sagittal plane images for:
[[File:Nasopharyngeal carcinoma-Axial T1 MRI.jpg|500px|none|thumb|source:https://radiopaedia.org/cases/nasopharyngeal-carcinoma-8?lang=us]]
** Detection of skull base invasion
[[File:Nasopharyngeal carcinoma MRI.jpg|500px|none|thumb|source:https://radiopaedia.org/cases/nasopharyngeal-carcinoma-8?lang=us]]
* A T2-weighted fast spin-echo sequence in axial plane images for:
** Evaluation  of early parapharyngeal tumor spread
** Invasion to pthe aranasal sinus
** Effusions of the middle ear
** Detection of cervical lymph nodes.
* Axial and coronal contrast-enhanced T1-weighted images (with and without fat suppression) are used to detect tumor extent, including perineural spread and intracranial extension of the tumor. The slice thickness is 3–5 mm . Additional MRI sequences may be used in the evaluation of NPC but, at present, are of limited proven clinical value, although whole body MRI for metastatic deposits of NPC is promising. Other reported MRI techniques include diffusion-weighted imaging, to aid in differentiating NPC from lymphoma and characterizing of cervical lymphadenopathy, and MRI spectroscopy, where choline-to-creatine ratios for the NPC and metastatic nodes are high compared with those for normal neck muscle .
MRI is an accurate test for the diagnosis of NPC. MRI depicts subclinical cancers missed at endoscopy and endoscopic biopsy and identifies patients who do not have NPC and who therefore do not need to undergo invasive sampling biopsies. NPCs usually present with intermediate signal intensity, higher than the muscle signal, on T2-weighted images, low signal intensity on T1- weighted images, and enhance to a lesser degree than does normal mucosa. Eighty-two percent of NPCs arise in the posterolateral recess of the pharyngeal wall (Rosenmüller fossa), and 12% arise in the midline. In 6–10% of patients, the nasopharyngeal mucosa appears normal at endoscopy


==References==
==References==
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]Faizan Sheraz, M.D. [3]

Overview

Head and neck MRI may be helpful in the diagnosis of nasopharyngeal carcinoma. It is especially used for the assessment of tumor invasion in the skull base, parapharyngeal spcae, paranasal sinus, middle ear and cervical lymph nodes.

MRI

MRI may be helpful in the diagnosis of Nasopharyngeal carcinoma.

  • Findings on MRI scan suggestive of nasopharyngeal carcinoma include:[1]
MRI Component Features
T1
T1 C+ (Gd)
  • Fat saturation in post contrast sequences
  • Notable heterogeneous enhancement is typical
  • Perineural extension should be sought
T2
  • Isointense to hyperintense to muscle signal
  • Fat saturation
  • Fluid in the middle ear can be helpful
source:https://openi.nlm.nih.gov/detailedresult?img=PMC4582819_13014_2015_513_Fig1_HTML&query=nasopharyngeal%20carcinoma&it=xg&req=4&npos=27
source:https://radiopaedia.org/cases/nasopharyngeal-carcinoma-8?lang=us
source:https://radiopaedia.org/cases/nasopharyngeal-carcinoma-8?lang=us

References

  1. ↑ Hermans, R (2012). Head and neck cancer imaging. Berlin New York: Springer. ISBN 9783642178689.
  2. ↑ Glastonbury, Christine M. (2007). "Nasopharyngeal Carcinoma". Topics in Magnetic Resonance Imaging. 18 (4): 225–235. doi:10.1097/RMR.0b013e3181572b3a. ISSN 0899-3459.
  3. ↑ Dubrulle, F.; Souillard, R.; Hermans, R. (2007). "Extension patterns of nasopharyngeal carcinoma". European Radiology. 17 (10): 2622–2630. doi:10.1007/s00330-007-0616-z. ISSN 0938-7994.
  4. ↑ Chin, Shy-Chyi; Fatterpekar, Girish; Chen, Cheng-Yu; Som, Peter M. (2003). "MR Imaging of Diverse Manifestations of Nasopharyngeal Carcinomas". American Journal of Roentgenology. 180 (6): 1715–1722. doi:10.2214/ajr.180.6.1801715. ISSN 0361-803X.
  5. ↑ Alfred L. Weber, Sharif al-Arayedh & Asma Rashid (2003). "Nasopharynx: clinical, pathologic, and radiologic assessment". Neuroimaging clinics of North America. 13 (3): 465–483. PMID 14631685. Unknown parameter |month= ignored (help)
  6. ↑ Julian Goh & Keith Lim (2009). "Imaging of nasopharyngeal carcinoma". Annals of the Academy of Medicine, Singapore. 38 (9): 809–816. PMID 19816641. Unknown parameter |month= ignored (help)
  7. ↑ Ng, Shu-Hang; Chan, Sheng-Chieh; Yen, Tzu-Chen; Chang, Joseph Tung-Chieh; Liao, Chun-Ta; Ko, Sheung-Fat; Wang, Hung-Ming; Wai, Yau-Yau; Wang, Jiun-Jie; Chen, Min-Chi (2009). "Pretreatment evaluation of distant-site status in patients with nasopharyngeal carcinoma: accuracy of whole-body MRI at 3-Tesla and FDG-PET-CT". European Radiology. 19 (12): 2965–2976. doi:10.1007/s00330-009-1504-5. ISSN 0938-7994.
  8. ↑ Fong, Devin; Bhatia, Kunwar S.S.; Yeung, David; King, Ann D. (2010). "Diagnostic accuracy of diffusion-weighted MR imaging for nasopharyngeal carcinoma, head and neck lymphoma and squamous cell carcinoma at the primary site". Oral Oncology. 46 (8): 603–606. doi:10.1016/j.oraloncology.2010.05.004. ISSN 1368-8375.
  9. ↑ Ann D. King, David K. W. Yeung, Anil T. Ahuja, S. F. Leung, Gary M. K. Tse & Andrew C. van Hasselt (2004). "In vivo proton MR spectroscopy of primary and nodal nasopharyngeal carcinoma". AJNR. American journal of neuroradiology. 25 (3): 484–490. PMID 15037477. Unknown parameter |month= ignored (help)

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