eCollection 2015. The lining may be formed by ectopic tissue such as gastric mucosa and pancreatic tissue. 79, No. Cervical neuroblastoma in a 3-year-old boy. Dermoid cysts may be hyperintense on T1-weighted images because of lipid-containing areas, and coronal imaging is useful in depicting the anatomic relationships of these lesions to the mylohyoid muscle (,1,,2,,11). A prevalence of one in every 20,000–40,000 live births has been reported, with 5% of teratomas in newborns situated in the lateral and anterior cervical region (,Fig 6,) (,1,,2). 2. Unable to load your collection due to an error, Unable to load your delegates due to an error. All three types of cysts are covered by squamous epithelium. Over 90% of branchial anomalies arise from the second branchial apparatus, with a predominance of cysts. Transverse T2-weighted MR image (a) and transverse (b), coronal (c), and sagittal (d) fat-saturated T1-weighted MR images obtained after intravenous injection of gadopentetate dimeglumine show a mass within the right masticator space (straight arrow), with associated infiltration of the superficial fasciae of the lower lip (arrowhead) and deep infiltration of the soft palate (curved arrow in a and b). Thyroglossal duct cysts may contain epithelial mucosal lining and ectopic thyroid tissue along the course of the duct (,1,,3,,4). Neck masses are a common finding in children and can present a difficult diagnostic challenge. Careful attention to clinical history and physical examination findings, along with knowledge of the embryologic features and anatomy of the cervical region and a multimodality imaging approach, is very helpful in the diagnosis and management of pediatric neck lesions. On axial contrast-enhanced CT scans and two-dimensional reformatted images, the thrombus appears as a hypoattenuating intraluminal filling defect surrounded by contrast material and the jugular vein wall (,Fig 9,,). About 50% of patients present before 20 years of age, and a second group presents during young adulthood. (a) Coronal fat-saturated T1-weighted MR image obtained after intravenous injection of gadopentetate dimeglumine shows a hypointense unilocular cyst with a slightly enhancing wall (arrow) close to the esophagus in the right retrovisceral space. Medical imaging is an important tool in the evaluation and classification of pediatric head and neck masses. Pediatric Neck Imaging image sequences, and contrast level that will provide the most definitive information for the patient. Embryonal rhabdomyosarcoma in a 3-year-old boy. Some neck masses are present at birth (congenital neck masses) due to abnormal formation during the early stages of pregnancy. Figure 5b. Septic jugular vein thrombophlebitis (Lemierre syndrome) in a 16-year-old girl. Parotid gland enlargement is often associated with diffuse cervical adenopathy. Figure 18b. MD. MR imaging is increasingly used in the pediatric population, offering superior soft tissue contrast for lesion characterization, assessment of lesion extent, and evaluation of the lesion to pertinent surrounding anatomic structures, which are important for … 60, No. 4.158 US/CT/MRI: midline cystic mass embedded in infrahyoid strap muscles. Bone destruction is common, as is intratumoral hemorrhage. Venous malformations are low-flow lesions supplied by small arteries. Thyroglossal duct abnormalities may be associated with thyroid malignancy in about 1% of patients (80% of the papillary type). Castellote A, Vázquez E, Vera J, Piqueras J, Lucaya J, Garcia-Peña P, Jiménez JA. Lymphadenitis and abscess in a 10-year-old boy. What is Known: • Pediatric neck masses are a common occurrence and often represent a diagnostic challenge. Imaging of granulomatous lesions of the neck in children. 2, Journal of Ultrasound in Medicine, Vol. Imaging is helpful in making an accurate diagnosis by means of a well-defined differential diagnosis. • Clinical features, serological exams and imaging findings should drive the physician to an appropriate diagnostic hypothesis. (c) CT scan (bone window) reveals additional infiltration of the C2 vertebral body by the mass (arrow). When portions of the jugular lymph sacs are pinched off, or when lymphatic spaces fail to connect with the main lymphatic channels, hygromas may occur (,6). Second branchial cleft cyst in a 13-month-old boy. They can be evaluated with ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging, either alone or in combination. (b) Axial US image depicts a hypoechoic lesion containing some slightly echogenic debris (arrow). The parathyroid glands arise from the third and fourth branchial pouches; most individuals have four parathyroid glands. The blood flow in the common carotid artery is clearly visible (arrow). Figure 16c. (c) CT scan (bone window) reveals additional infiltration of the C2 vertebral body by the mass (arrow). 38, No. Dividing the causes according to structure of origin is a useful schema. The fasciae of the neck are well-defined sheets of fat and fibrous tissue that circumscribe several compartments or spaces. The cysts are hyperintense on the T2-weighted images and demonstrate peripheral wall enhancement on the T1-weighted image. Radiol Clin North Am. They may extend inferiorly into the axilla and mediastinum or into the floor of the mouth and the tongue (,9,,10). Heterogeneity seen in the cyst is due to the proteinaceous content of the cyst rather than to inflammation or infection (,2,,3). 2006 May;15(2):99-106 It contains the trachea, larynx, cervical esophagus, recurrent laryngeal nerves, and the thyroid and parathyroid glands. Sagittal (a) and coronal (b) T2-weighted MR images show a hyperintense midline cystic mass of the foramen cecum (arrow). A complete circumferential rim of enhancement is the hallmark of abscess, whereas partial or no enhancement indicates a phlegmon. (a) Axial protondensity–weighted MR image shows a hyperintense mass (arrow). Note also the posterior necrotic zone of the mass (arrowhead in b). After reading this article and taking the test, the reader will be able to: Discuss a wide variety of congenital and acquired conditions of the pediatric neck. At US, lymphatic malformations manifest as a multilocular, predominantly cystic mass with septa of variable thickness. Figure 9c. Viewer, US of Pediatric Superficial Masses of the Head and Neck, Evaluation and Management of Pediatric Neck Masses, Sonography of pediatric superficial lumps and bumps: illustrative examples from head to toe, Evaluation of an imaging protocol using ultrasound as the primary diagnostic modality in pediatric patients with superficial soft tissue infections of the face and neck, Correlation between pre-operative diagnosis and post-operative pathology reading in pediatric neck masses—A review of 281 cases, Magnetic Resonance Imaging (MRI) in the Diagnosis of Head and Neck Disease, Rapid Spontaneous Resolution of Fibromatosis Colli in a 3-Week-Old Girl, Characterization of head and neck lesions with diffusion-weighted MR imaging and the apparent diffusion coefficient values, Burkitt Lymphoma as a Cause of Carotidynia: Imaging Features, Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients, Head and Neck Ultrasound in the Pediatric Population, Neck Masses in Children: Current Imaging Guidelines and Imaging Findings, Sonography for Diagnosis of Cervical Ribs in Children, Imaging manifestations of neck masses in the immunocompromised host, Imaging Evaluation of Pediatric Parotid Gland Abnormalities, US-guided Biopsy of Neck Lesions: The Head and Neck Neuroradiologist’s Perspective, Congenital Oral Masses: An Anatomic Approach to Diagnosis, Infectious Emergencies of the Head and Neck: What Every Radiologist Needs to Know to Save Your Life, Ultrasound Imaging of Pediatric Neck Masses: What Radiologists Need To Know.
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