Pediatric neck masses: review of MR imaging features of common and uncommon lesions

Congress:

ECR 2019

Poster Number:

C-2617

Type:

Educational Exhibit

Keywords:

Education and training, Diagnostic procedure, MR, Paediatric, Head and neck

Authors:

D. Fonseca¹, D. F. Soares², J. G. Santos³, S. L. Rodrigues⁴, L. H. C. B. Samouco⁵, S. Dias³; ¹Senhora da hora/PT, ²201/PT, ³PORTO/PT, ⁴Chaves/PT, ⁵101/PT

DOI:

10.26044/ecr2019/C-2617

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2617

Fig. 4: 15 years old adolescent undergoing MR for follow-up of lymphoma. MR depicts an...

Fig. 12: 8 years old boy presents with a mass superficial to the right hemimandible. On...

Fig. 13: 13 years old boy presenting with a painful mass in the left posterior neck...

Fig. 1: 5 years old boy with thyroglossal duct cyst. MR T1 and T2 weighted images...

Learning objectives

To review and illustrate Magnetic Resonance (MR) imaging features of common and uncommon neck masses in the pediatric age group.

Background

Neck masses in the pediatricage groupare mostly of congenital, inflammatory or neoplastic etiology. In this review we will focus on congenital and neoplastic etiology, as most inflammatory masses areimaged with ultrasound and/or CT (e.g lymphadenitis, scrofula, retropharyngeal and peritonsilar abscess and salivary gland inflammation). Diagnostic approach is initially centered on establishing the origin of the mass and if it is of cystic or solid nature. Our goal as radiologists is to help to ensure a diagnosis or limited differential. Ultrasound is generally the first imaging...

Findings and procedure details

CONGENITAL LESIONS Thyroglossal duct cyst The most frequent pediatric midline neck mass and tipically presents as a mobile midline asymptomatic mass, although occasionaly they may become symptomatic due to infection. They occur along the midline upper neck, from the base of the tongue to the isthmus of the thyroid gland, due tofailure of obliteration of thethyroglossal ductduring development. Usually this patients are diagnosed with ultrasound. On MR they usually show simple cystic appearance (Fig. 1), with high signal intensity on T2 and low signal intensityon...

Conclusion

Pediatric neck masses are a diagnostic challenge both for the clinician and the radiologist. Knowing the most common diagnosis and learningtheir imaging features on MR can help classifying the lesions and shorten the list of differential diagnosis.

Personal information

References

Brown RE, Harave S; "Diagnostic imaging of benign and malignant neck masses in children—a pictorial review";Quant Imaging Med Surg 2016; 6(5):591-604; Vazquez E,Enriquez G,Castellote A,Lucaya J,Creixell S,Aso C,Regas J; "US, CT, and MR imaging of neck lesions in children"; RadloGraphics 1995; 15:105-122; Meuwly JY,Lepori D,Theumann N, Schnyder P,Etechami G,Hohlfeld J, Gudinchet F; "Multimodality Imaging Evaluation of the Pediatric Neck: Techniques and Spectrum of Findings";RadioGraphics 2005; 25:931–948; Meier JD, Grimmer JF; "Evaluation and Management of Neck Masses in Children";Am Fam Physician.2014; 89(5):353-358; Flors L,Leiva-Salinas C,Maged IM,Norton...