FLEX February 2024

Imaging of Pediatric Head and Neck Masses

a,b, *, Daniel T. Ginat,

c ,

Jessica S. Stern, MD

MD, MS

a,b , Maura E. Ryan,

a,b

Jennifer L. Nicholas, MD, M.H.A

MD

KEYWORDS Imaging Pediatrics Head and neck masses

KEY POINTS

Ultrasound is often the initial imaging examination for evaluation of pediatric neck masses. Doppler interrogation is useful for evaluating vascularity. MRI and CT are complementary modalities, particularly in evaluating the deep cervical structures. CT is helpful in evaluating infectious and inflammatory processes, as well as in providing information regarding calcification. MRI is useful in characterization of soft tissue lesions, and evaluation of enhancement characteristics. Minimizing the risks of radiation and sedation must be considered in the imaging work up of a pediatric neck mass.

INTRODUCTION

Imaging is often an essential component in evaluating pediatric neck masses and can be helpful in characterizing congenital, inflammatory, vascular, and neoplastic le sions. 1 In some cases, characteristic imaging appearances can be diagnostic. In other instances, imaging may not yield a definitive diagnosis, but can be helpful in narrowing the differential diagnosis, defining lesion extent, assessment for metastatic disease, and in follow-up evaluation for treatment response or recurrence. Imaging workup must consider the risks and benefits associated with various modalities, particularly the risks of sedation and radiation. Ultrasound is typically the initial imaging performed for evaluation of a palpable pediatric neck mass as it utilizes no radiation, requires no sedation or intravenous contrast, is easily accessible, and is a Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, North western University, 225 East Chicago Avenue, Box 9, Chicago, IL 60611, USA; b Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; c Department of Radiology, Pritzker School of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA * Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, North western University, 225 East Chicago Avenue, Box 9, Chicago, IL 60611. E-mail address: JStern@luriechildrens.org

Otolaryngol Clin N Am 48 (2015) 225–246 http://dx.doi.org/10.1016/j.otc.2014.09.015

oto.theclinics.com

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