Multi Detector Computed Tomography and Ultrasound Evaluation of Neck Masses with Pathological Correlation

Introduction: Neck imaging has always been a diagnostic challenge. High-resolution sonography being inexpensive and safe has become the initial investigation of choice for neck pathologies; it provides information regarding the origin and extent of the lesion. Computed tomography (CT) has a unique capacity for displaying soft tissue, bone and airway details and provides critical anatomical information about lesions involving the neck. This study aims to determine the role of USG and CT in neck masses for pre-operative characterization based on location, extent, morphological characteristics and enhancement pattern and to compare USG and CT findings with histopathological diagnosis.

Material and Methods: A total number of 60 adult patients with suspected neck masses were studied in the department of Radiodiagnosis, SSIMS&RC, Davanagere and inputs from Dr. B. R. Ambedkar Medical College, Bengaluru over a period of 24 months. Ultrasound was done using GE Voluson E6 machine & Contrast enhanced CT was done using GE Revolution Multidetector CT scan machine. Post processing techniques (like volume rendered techniques) were applied wherever useful.

Results: The findings on USG and CT were conclusive in nearly 90% of cases. Enhancement patterns and presence/absence of bony invasion were found to be more specific in differentiating benign/malignant nature.

Conclusion: High-resolution sonography can be used as the first-line modality for evaluating cervical soft tissue masses, it helps the clinicians to characterize the lesion. Multi-detector computed tomography is a sensitive diagnostic tool for diagnosing neck masses and differentiating between benign and malignant lesions with high accuracy. The extent of pathology with local/ contiguous spread predicted by CT examination was conclusive. The overall findings suggest that MDCT and Ultrasound, when used in conjunction with pathological correlation, can be effective tools for accurately characterizing and diagnosing the neck masses.