MRI-guided access to the retropharynx

Purpose To describe MR-guided access to the retropharynx for precise fine-needle aspiration cytology (FNAC), and other indications for needle placement. Materials and Methods A retrospective review was made of 15 procedures that had been performed on 14 patients. These patients had a retropharyngeal mass on MRI and had undergone MR-guided minimally invasive access to the retropharynx for either diagnostic or therapeutic intervention in the period of October 1989 to January 2000. Results All 14 patients underwent MR-guided access to the retropharynx for FNAC without immediate or delayed complications. MRI confirmed that the biopsy needle was within the retropharyngeal mass in all patients. MR-guided FNAC revealed five true-positive, five true-negative, four indeterminate, and no false-positive cases. Ten of the 14 patients (71%) had diagnostic aspirations. In one patient with retropharyngeal extension of carcinoma, an MR-guided approach was used for the experimental interstitial laser therapy (ILT). Conclusion The results suggest that an MR-guided retromandibular approach to biopsy of retropharyngeal mass is minimally invasive and safe. J. Magn. Reson. Imaging 2003;17:317–322. © 2003 Wiley-Liss, Inc.