The application of magnetic resonance imaging-guided fine-needle aspiration cytology in the diagnosis of deep lesions in the head and neck.
OBJECTIVE
Image-guided fine-needle aspiration cytology (FNAC) may be useful as an alternative diagnostic approach to lesions in the head and neck. This study reports on the use of magnetic resonance imaging (MRI)-guided FNAC for diagnostic evaluation of deep lesions in this region.


METHODS
This was a prospective study of 12 patients with deep lesions in the head and neck who underwent MRI-guided FNAC at the Shanghai 9th People's Hospital. A 0.2-T open magnet was used for MRI and localization of the 20-gauge MRI-compatible needle. All of the aspirated samples were stained with hematoxylin and eosin and examined by a cytopathologist.


RESULTS
The needle in all 12 cases was displayed on MRI in the central portion of the lesion under the guidance of MRI; 12 of 12 patients (100%) had diagnostic aspirations and none needed open biopsy for more specific histologic interpretation. Six of these 12 patients with tumors (4 malignant, 2 benign) underwent operative treatment with positive postoperative pathologic results. One patient had a diagnosis of inflammation. The diagnostic accuracy was 91.67% (11 of 12), the sensitivity was 85.71% (6 of 7), and the specificity was 100% (5 of 5). There were no false-positive results and 1 false-negative result, for a false-negative rate of 14.29% (1 of 7). All aspiration procedures were well tolerated and without complications.


CONCLUSIONS
MRI-guided FNAC is a cost-effective tool for establishing tissue diagnosis as a primary investigative modality. It is helpful and accurate in the diagnosis of deep lesions in the head and neck and in follow-up of patients, thereby avoiding further surgical intervention.
Department of Oral and Maxillofacial Surgery, Shanghai 9th People's Hospital, Shanghai, China.
Yue
Y
He
Zhiyuan
Z
Zhang
Zheng
Z
Tian
Chenpin
C
Zhang
Huanguang
H
Zhu
D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D003581:Cytodiagnosis; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology; D010309:Parotitis / Q000473:pathology; D011446:Prospective Studies; D015642:Radiology, Interventional; D012680:Sensitivity and Specificity