26F, CT PNS shows severe pansinusitis + incidental 28mm parapharyngeal lesion — would contrast MRI substitute for the recommended CECT neck?

26F, India. Nasal polyp visible at the nostril, FESS planned. Currently on prednisolone 5 days + clarithromycin pre-op.

Non-contrast CT PNS (done 03 Aug) showed:

– Severe pansinusitis, all sinuses, with hyperdensities within — reported as likely chronic/fungal

– Soft tissue into right nasal choana — likely antrochoanal polyp

– Complete occlusion of bilateral OMC, frontal and sphenoethmoidal recesses

– DNS to left, bilateral concha bullosa, inferior turbinate hypertrophy

– **Well-defined hypodense lesion 28x23mm, right parapharyngeal space** — radiologist suggested CECT neck for characterisation

– Right tonsillolith (same side)

She's concerned about cumulative radiation, especially thyroid dose. My questions:

1. Would a contrast MRI neck (with DWI) answer what the CECT was asked for — enhancement characteristics, full neck coverage, carotid relationship?

2. Is there a reason to insist on CECT here that I'm missing? I'm aware she's completely blocked nasally and mouth-breathing, so a 30-min neck MRI may have motion artefact.

3. Any views on the parapharyngeal lesion itself given the ipsilateral tonsillolith?

Asking the ENT surgeon too — just want to know whether the question is reasonable before I raise it. Thanks.

PS: Used AI to enhance the question.