Transcript Soft Tissue Neck in CT

Soft Tissue Neck
IN COMPUTED TOMOGRAPHY
Frank Cairo R.T. ( R ) ( CT ) ( MR )
Learning Objectives
• To describe clinical indications for C.T.
examinations of the neck soft tissue. To
understand and recognize anatomy and
landmarks. To show the proper scan protocols
and procedures.
TOPICS
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Gross anatomy
Neck anatomy facts
Patient prep
Indications
Patient prep
Scan protocols
Soft tissue neck slides
Gross Anatomy
Hyoid Bone
• A horseshoe-shaped bone situated in the
anterior midline of the neck between
the chin and the thyroid cartilage
• Level with the third cervical vertebra (C3)
behind
• The hyoid is only distantly articulated to other
bones by muscles or ligaments
Hyoid Bone
Hyoid Bone
Thyroid Cartliage
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Know as the Adams apple
Largest and most superior in the neck
Level with C3-4
protect the vocal cords
Does not make a ring around trachea
Thyroid Cartliage
Cricoid Cartliage
• At the level of C6
• Makes a ring around trachea
• Applies attachments for muscles and
ligaments
Cricoid Cartliage
Thyroid Gland
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Largest gland in the neck
Has 2 lobes connected by the isthmus
Sometimes had pyramidal lobe
Controls how quickly the body uses energy,
makes proteins, and controls how sensitive
the body is to other hormones
• Produces thyroid hormones
Thyroid Gland
Carotid Anatomy
Carotid Artery
Veins of the neck
Veins of the neck
Neck Circulation
1- rt common carotid artery
2- rt internal jugular vein
3- rt.subclavian artery
4- brachiocephalic artery
5- rt and lt brachiocephalic vein
6- SVC
7- lt common carotid artery
8- lt internal jugular vein
9- lt.subclavian artery
10 – arotic arch
Lymph Nodes
Lymph Nodes
Salivary Glands
• exocrine glands, glands with ducts, that
produce saliva
• Saliva for chemical digestion
• 3 main glands and several minor
• Parotid, Submandibular, and Sublingual
Salivary Glands
Salivary Glands
Airway
General Imaging Methods—Neck
• Performed supine with neck slightly extended
• Most often done in helical mode
• IV contrast is used, unless contraindicated
– Split-bolus injection technique is used by some institutions
• The goal is to allow sufficient time after contrast administration for
mucosa, lymph nodes, and pathologic tissue to enhance, yet acquire
images while the vasculature remains opacified
Neck Anatomy Facts
• Neck broken into 3 compartments
– Visceral
• Contains organs
– Vascular
• Contains arteries and veins
– Muscular
• Neck muscles
– Landmarks
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Larynx c3-c6
Cricoid cartilage c5-c6
Carina T4-T5
Carotid bifurcation c3-c4
Thyroid cartilage c3-c4
Indications
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Diagnosis of neoplasms
Infections and abscesses
Thyroid mass
Salivary gland disorders
Vocal cord disorders
Patient Preparation
• If exam is done with I.V. contrast patient must be
NPO 4-6 hours
• Lab work for I.V. contrast exams
• Follow all routine precautions for contrast
SINUSES
COLLIMATION
0.75mm
SLICE THICKNESS
3-5MM
FOV
14-20 CM
PITCH
1.0
WINDOW
450/30 NECK
COLLIMATION
16X0.75
FEED/ROTATION
12 MM
INJECTION
100-120 ml @ 2-3ml/sec delay 25-30 sec
4000/300 BONE
Soft Tissue Neck
1- SVC
2- Brachiocephalic
Artery
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3- Lt. Common
Carotid
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4- Lt. Subclavian
Artery
Soft Tissue Neck
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1- Thyroid Gland
2- Common Carotid
3- Internal Jugular
4- Verterbral
5- Rt Subclavian
Bifurcation
Below
Above
cc
cc
Ic
Ec
Neck
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1- Internal Juglar vein
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2- Submandibular Gland
3- Carotid Biufcuation
4- Hyoid Bone
5- epiglottis
6- Vertebral Artery
Neck
1- Vertevbral Artery
Salivary Gland
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1- Parotid Gland
Salivary Gland
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1- Submandibular
Gland
Neck
1- Basilar Artery
2- Internal Carotid
Soft tissue neck
--85-year-old woman with metastases from squamous cell carcinoma of hypopharynx
Groell, R. et al. Am. J. Roentgenol. 2001;176:1571-1575
Copy right © 2007 by the American Roentgen Ray Society