"Black bone" MRI: a potential alternative to CT when imaging the head and neck: report of eight clinical cases and review of the Oxford experience

Br J Radiol. 2012 Nov;85(1019):1457-64. doi: 10.1259/bjr/16830245.

Abstract

Objective: The potential risks associated with ionising radiation are well documented. We have previously reported the "black bone" MRI sequence, useful when imaging cortical bone. The objective of this paper is to report our initial experience of this technique in patients undergoing imaging of the head and neck region.

Methods: Using the departmental database those patients having had "black bone" sequences of the head and neck performed as part of their MRI examination in the preceding 5 years were identified. The radiological reports were reviewed to identify those cases where "black bone" or conventional MRI sequences had been performed in place of the requested CT, and the patient medical records for these cases were reviewed. Medical record review was also conducted for those cases where it was considered that the pathological condition requiring imaging would ordinarily be investigated with CT.

Results: The "black bone" sequence had been performed in 69 patients as part of routine MRI of the head and neck. Of these, 67% (n=46) were performed in combination with CT imaging, the majority of cases being primary tumours. In four cases, an MRI was performed in place of the requested CT scan. We present eight clinical cases illustrating the potential benefits of the "black bone" sequence.

Conclusions: "Black bone" MRI offers a radiation-free method of imaging the head and neck, and has been successfully utilised in a range of benign and malignant conditions affecting this region. Advances in knowledge Adoption of this approach, where feasible, would be a significant advance in radiation protection.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Craniocerebral Trauma / diagnosis
  • Craniocerebral Trauma / diagnostic imaging
  • Craniocerebral Trauma / pathology
  • Female
  • Head / diagnostic imaging
  • Head / pathology*
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / pathology
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Mandibular Diseases / diagnosis
  • Mandibular Diseases / diagnostic imaging
  • Mandibular Diseases / pathology
  • Middle Aged
  • Neck / diagnostic imaging
  • Neck / pathology*
  • Odontogenic Cysts / diagnosis
  • Odontogenic Cysts / diagnostic imaging
  • Odontogenic Cysts / pathology
  • Tomography, X-Ray Computed
  • Young Adult