الفهرس 
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Abstract
Diffusion-weighted magnetic resonance imaging (DW-MRI) has been introduced in the evaluation of head and neck cancers. It is based on the relative mobility of water molecules in different tissues and provides information about the microenvironment such as cell density, cell integrity and vascularity. DW-MRI is used to measure differences in tissue microstructure that are based on the random displacement of water molecules. These differences in water mobility are quantified by using the apparent diffusion coefficient (ADC). Measurement of ADCs calculated from DW-MRI may be used in characterization of laryngeal and hypopharyngeal lesions and early detection of their malignancy. Diffusion-weighted imaging (DWI) quantified by (ADC) help in tissue characterization, diagnosis of new cases and early detection of Residual/Recurrent laryngeal and hypopharyngeal tumours after treatment with (chemo) radiotherapy(CRT) as it allows differentiation of post-CRT inflammation and necrosis(treatment-induced tissue changes)from recurrent malignancy. Historadiological correlation has shown an inverse correlation between the ADC and lesion cellularity.
The current study is a cross sectional analytical study. The patients of this study were recruited from otorhinolaryngology department and oncology department, Menoufia University and radiology department of national liver institute.
All patients were subjected to history taking to assess patients presenting with new onset of hoarseness of voice, difficulty in breathing up to stridor, dysphagia and or worsening of symptoms after chemo/radiotherapy in patients previously diagnosed with laryngeal or hypopharyngeal cancers. Complete otorhinolaryngology examination
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including neck examination was performed for all patients with telescopic examination of larynx and hypopharynx done to verify presence of abnormality as masses or any change of previous examination of the same patient. Diffusion weighted MRI on neck with emphasis on larynx, hypopharynx was done .All patients were scanned at radiology department, national liver institute, Menoufia university on the same GE MRI SCANNER OptimaTM MR450wGEM-70cm,DW-MRI was performed as Axial T2 fat sat, Diffusion WIs with b values 0, 500 and 1000. Direct laryngoscopic examination of larynx and hypopharynx under general anesthesia was done with taking biopsies from suspicious lesions for histopahological examination. Comparison between results of both methods were then assessed and analyzed.
In the current study, MRI with diffusion had 100% Sensitivity, 82% Specificity with accuracy of 88% in comparison to histopathological findings of biopsies from the studied group.
In conclusion, DW-MRI is considered a diagnostic tool in various body cancers especially in the head and neck with ability to detect recurrence after treatment .It is also used increasingly as biomarker for early prediction of treatment response to chemo-radiotherapy (CRT). DW-MRI has predictive value in detection of laryngeal and hypopharyngeal cancers in new cases and role of exclusion of tumour recurrence post chemo-radiotherapy in cases with suspicious lesions after completion of treatment.
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