MRI is assuming a dominant role in imaging of the larynx. Its superior
soft tissue contrast resolution makes it ideal for differentiating
invasion of tumors of the larynx from normal or more sharply
circumscribed configuration of most of the benign lesions. Over ten
years ago CT made a major impact on laryngeal examination because it was
the first time that Radiologists were beginning to look at submucosal
disease. All of the previous examinations duplicated the infor- mation
that was available to the clinician via direct and in-direct laryngo-
scopy. With the advent of rigid and flexible endoscopes, clinical
examination became sufficiently precise that there was little need to
perform studies such as laryngography which merely showed surface
anatomy. The status of deep structures by these techniques was implied
based on function. Fortunately laryngography is now behind us together
with all of the gagging and contrast reactions which we would all like
to forget. CT is still an excellent method of examining the larynx but
it is unfortunately limited to the axial plane. With presently available
CT techniques motion deteriorates any reformatting in sagittal or
coronal projections. The latter two planes are extremely helpful in
delineating the vertical extent of submucosal spreads. MRI has proven
extremely valuable by producing all three basic projections, plus
superior soft tissue contrast. Although motion artifacts still degrade
the images in some patients, newer pulsing sequences that permit faster
scanning are elimi- nating most of these problems.