Infection of the deep neck spaces is a life-threatening acute illness that requires prompt diagnosis and treatment. Magnetic resonance imaging (MRI) offers unsurpassed soft tissue discrimination and is therefore well suited for imaging neck infections. Recently, the feasibility, diagnostic accuracy, and clinical significance of this method have been documented in patients with acute neck infections. This review article summarizes the scientific evidence, provides a practical guide to image acquisition and interpretation, reviews the most common imaging findings, and discusses some difficult diagnoses and pitfalls in acute neck infections, to help both radiologists and clinicians in managing these critically ill patients.
Key points: MRI of acute neck infections is feasible in most patients.Most common types are pharyngotonsillar and odontogenic infections.MRI has high diagnostic accuracy for abscesses in adults and children.MRI shows reproducible edema patterns that have clinical and prognostic significance.