Computer tomography of the neck
Last reviewed: 23.04.2024
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If there are no contraindications, computed tomography of the neck is performed after intravenous administration of contrast medium. The use of contrast preparations allows to determine more reliably the presence of malignant neoplasm and inflammatory process. To adequately enhance the vessels of the neck, more contrast material is required than, for example, for computed tomography of the head. With spiral computed tomography, scanning should begin at a specific time after the injection of the contrast drug. Special recommendations and schemes for the introduction of contrast media are at the end of this guide.
Method of computed tomography of the neck
By analogy with the computed tomography of the head, a lateral topogram is first performed. On this topogram, the levels of transverse (axial) scanning and the angle of rotation of the gantry are outlined. The usual sections of the neck are set to a thickness of 4 - 5 mm. Axial images are obtained on the monitor screen and when transferred to the printer as a bottom view (from the caudal side). Thus, the right lobe of the thyroid gland is shown to the left of the trachea, and the left lobe is on the right.
Method of computed tomography of the neck
Sequence analysis of CT images
For computed tomography of the neck there is not only one correct technique, but several systems for the interpretation of tomograms. The recommendations presented here were developed on the basis of clinical experience and are one of the many choices for beginners. Each specialist in the process of work is free to choose his strategy.
Analysis of CT images of the neck
Normal anatomy of the neck
The radiologist quickly encounters the limit of the resolution of computed tomography (and also, probably, his knowledge of anatomy) when he tries to identify each cervical muscle. Muscles individually are not of great clinical significance.
Sections of the neck usually begin with the base of the skull and continue in the cauladral direction to the upper aperture of the thorax. Therefore, sections that capture the head include images of the maxillary sinuses, nasal cavity and pharynx. Behind the throat are the long muscles of the head and neck, which continue downward (caudal).
Computer tomography of the neck is normal
Neck pathology
Enlarged cervical lymph nodes are visualized as isolated nodal formations within a single cut and are rarely detected in adjacent sections. In lymphomas of large sizes and in conglomerates of lymph nodes, there are often areas of central necrosis. In these cases, it is difficult to distinguish them from an abscess with central decay. Usually the abscess is surrounded by a zone of infiltration of fatty tissue, the density of which is increased due to edema, resulting in poorly discernible nerve trunks, arteries and veins. In patients with immunodeficiency abscesses can reach very large sizes. After the introduction of contrast medium, the outer wall and internal septa of the abscess are strengthened. The same picture is typical for a large hematoma or tumor with decay. In this case, it is difficult to make a differential diagnosis without a detailed study of the anamnesis.
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