Learning objectives
To address computed tomography (CT) technical considerations for optimal diagnostic imaging.
To review the anatomic spaces of the neck and its components.
To review the characteristic imaging features and illustrate a wide range of lesions of the various neck spaces.
Background
Neck lesions are common findings in paediatric patients and can be challenging for the radiologists involved.
Such lesions can be classified as congenital,
vascular,
inflammatory or tumoural.
Many of these masses are asymptomatic and noticed incidentally by patients / parents or on physical examination.
Whereas others are brought to clinical attention because of the mass effect on the aero-digestive tract or symptoms related to acute infection,
pain or cosmetic deformity.
Imaging is not only useful in reaching a differential diagnosis list,
but may be helpful...
Findings and procedure details
Imaging modalities
US is the initial imaging modality of choice,
as diagnosis can be achieved in many cases.
CT and MR may have a supplementary role,
mainly in profound and atypical lesions.
As CT has ionizing radiation and paediatric patients are especially susceptible to it,
optimal CT protocol is fundamental.
A CT protocol is suggested below.
Technical Parameters
kVp
120
Effective mAs
40-55
3-6 YO
55-70
6-12 YO
70-95
>12 YO
120
Time (rotation)
1.0
Average acquisition time
6-8 sec
Collimation
64x0.6 mm
Pitch value...
Conclusion
There is a wide range of clinical and radiological manifestations of neck lesions.
Awareness of the typical topography and appearance allows prompt diagnosis and determines management.
References
• Friedman ER,
John SD.
Imaging of Pediatric Neck Masses.
Radiol Clin N Am,
2011,
49:617-632
• Brown RE,
Harave S.
Diagnostic imagin of benign and malignant neck masses in children – a pictorial review.
Quant Imaging Med Surg,
2016,
6(5):591-604
• Rosenberg HK.
Sonography of Pediatric Neck Masses.
Ultrasound Quarterly,
2009,
25(3):111-127
• Tranvinh E,
Yeom KW,
Iv M.
Imaging Neck Masses in the Neonate and Young Infant.
Semin Ultrasound CT MRI,
2015,
36:120-137
• Koeller KK,
Alamo L,
Adair CF,
Smirniotopoulos JG.
Congenital...