The aim of this course: The aim of this course is to offer an in-depth knowledge of current MR imaging techniques for the diagnosis of head and neck lesions. The course will provide the participant with an update on fundamental and advanced sequence protocols to image the different head and neck regions. A comprehensive coverage of the MR signal of the normal tissues will give the preliminary basis for head and neck anatomy. We will focus on imaging strategies, recent developments and specific MR findings to characterise head and neck congenital, inflammatory, benign and malignant diseases. Special emphasis will be placed on differential diagnosis and on grading tumour extent. The course will provide a combination of lectures and case based interactive teaching in small groups.
Participation Requirements: Physicians who have attended the School of MRI Applied MR Techniques Courses or have good knowledge in MR techniques from other sources; minimum of 6 months experience in applied Head and Neck MRI.
Basic and Advanced MR Imaging Techniques • DW Imaging
• IVIM DW derived perfusion-fraction Imaging (D*)
• Which sequences on head and neck on 3T?
• 3T Isotropic and non-isotropic high-res imaging
• DCE-MR: Which use in the head and neck?
• Isotropic T1w and T2w imaging at 1.5T
• Imaging arteries and veins. Black blood, TOF, PC, CE-MR
MR Signal of Normal and Abnormal Tissues • Normal and abnormal fat on different sequences
• The signal intensity of water, CSF, mucus, saliva, and »cysts«
• The cortical and cancellous bone. Erosion, sclerosis, invasion
• The normal mucosa. Edema and scar
• Normal findings of cranial nerves, arteries, veins, and dural sinuses
MR Imaging of the Sinonasal Tract and the Skull Base • MR anatomy of the anterior skull base floor, orbit, pterygopalatine fossa, cavernous sinus and Meckel’s cave
• MR examination of the sinonasal tract and anterior skull base
• Polypoid masses. Feasibility of endonasal surgery. Grading skull base invasion. MR in predicting orbit preservation
MR Imaging of the Nasopharynx and Parapharyngeal Space • MR anatomy of the nasopharyngeal walls and parapharyngeal space
• How to study the nasopharynx and parapharyngeal space lesions
• Differential diagnosis of submucosal masses
• MR patterns of pre- and post-styloid masses
• Staging nasopharyngeal neoplasms
MR Imaging of the Oropharynx and Oral Cavity • MR anatomy of key oral cavity structures
• MR strategies to image flaps and post-treatment changes
• Role of DCE-MR and DWI imaging
• Role of MR in detecting mandible invasion. Perineural spread and bone invasion
MR Imaging of Major and Minor Salivary Glands • MR anatomy of key landmarks
• Fat sat sequences, DCE-MR and DWI imaging. MR Sialography
• Distinguishing parapharyngeal from parotid gland »deep lobe« tumours
Surface Coil MR Imaging of the Larynx and Hypopharynx • How to image the larynx and hypopharynx: tips and tricks
• Which sequences? Which study planes?
• New insights on muscles and fat spaces: high-res anatomy
• How to recognize edema of fat, muscles and cartilage
MR Imaging of Lymph Nodes and Lumps in the Neck • Imaging techniques to detect and characterize neck nodes. Which role for DWI?
• Retrolatero-pharyngeal and parotid nodes
• MR of cystic, vascular and solid masses in the neck
• The unknown primary. Is MR imaging useful?
MR Imaging of Temporal Bone and CPA Lesions • MR anatomy of VII and VIII cranial nerves. The normal membranous labyrinth. Landmarks for the jugular foramen
• Imaging temporal bone and CPA lesions. 3D T2 sequences
• DWI imaging
• Inner ear malformations: is cochlear implant feasible? Neuro-vascular conflict. Detecting the recurrent cholesteatoma
MR Imaging of the Orbit • MR anatomy and imaging techniques
• Extra-ocular vascular lesions: cavernous hemangioma, lymphatic malformations, varices, AV malformations
• Inflammatory pseudotumour, lymphoma and orbital metastasis
• Thyroid opthalmopathy: MR Imaging