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Neck Ultrasound Guidelines

The document discusses ultrasound of the neck, focusing on lymph nodes and cysts. It notes that cysts often appear solid rather than cystic on ultrasound, while solid masses can sometimes appear cystic. Common pseudo-cystic masses include lymphoma, pleomorphic adenoma, nerve sheath tumors, and parathyroid adenomas. The document also reviews lymph node anatomy in the neck and techniques for ultrasound-guided biopsy.

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187 views102 pages

Neck Ultrasound Guidelines

The document discusses ultrasound of the neck, focusing on lymph nodes and cysts. It notes that cysts often appear solid rather than cystic on ultrasound, while solid masses can sometimes appear cystic. Common pseudo-cystic masses include lymphoma, pleomorphic adenoma, nerve sheath tumors, and parathyroid adenomas. The document also reviews lymph node anatomy in the neck and techniques for ultrasound-guided biopsy.

Uploaded by

alen
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Ultrasound of the Neck

www.headandneckultrasound.co.uk

Rhodri M Evans
Ultrasound.

• Rules
• Lumps – cysts and nodes.
• Needles.
Lumps and bumps.
Rules .
• Cysts look solid.
• Solids can look cystic.
Rules .
• Cysts don’t usually look like cysts.
• Cysts will invariably look solid.
• If a mass looks cystic,it probably won’t be
a cyst.
• Solids can look cystic
Rules .
• Cysts don’t usually look like cysts.
• Cysts will invariably look solid.
• If a mass looks cystic,it probably won’t be
a cyst.
• Solids can look cystic
Cystic?
Pseudo-cystic?
Pseudo-cystic?
• Lymphoma.
• Pleomorphic adenoma.
• Nerve sheath tumour.
• Parathyroid adenoma.
Normal lymph nodes.
Normal lymph nodes.
Normal lymph nodes.
Normal lymph nodes.
Lymphoma?
Lymphoma
Metastatic lymph nodes
Malignant lymph nodes.
Metastatic lymph nodes
Metastatic lymph nodes
Metastatic lymph nodes
Normal lymph nodes.
Normal lymph nodes.
Malignant lymph nodes.
Malignant lymph nodes.
Malignant lymph nodes.
Malignant lymph nodes.
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Submental

Digastric

Mylohyoid
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Submandibular
Facial artery & vein

Retro-
Mandibul
ar vein

Digastric
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Superficial
Pre-auricular Parotid

Sub fascial
Pre-auricular

Sub fascial
Infra-auricular
Deep intraglandular
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
masseter

Facial artery

mandible buccinator
mucosa
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Deep Cervical Chain

Omohyoid

CCA
IJV
Deep Cervical Chain
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Sternomastoid
Transverse
Cervical
Scalenus anterior

Clavicle

Subclavian vein

Subclavius

Pectoralis
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Anterior Cervical

Pre Tracheal

Para
Tracheal

CCA

Longus Colli
Lymph Node Examination

3
4
5
8 2 1
6
10
7
9
Pseudo-cystic?
• Lymphoma.
• Pleomorphic adenoma.
• Nerve sheath tumour.
• Parathyroid adenoma.
? Lymphoma
? Lymphoma
? Lymphoma
Pseudo-cystic?
• Lymphoma.
• Pleomorphic adenoma.
• Nerve sheath tumour.
• Parathyroid adenoma.
Rules .
• Cysts don’t usually look like cysts.
• Cysts will invariably look solid.
• If a mass looks cystic,it probably won’t be
a cyst.
• Solids can look cystic
Cystic mass – upper cervical.
• Second Branchial cleft cyst.
• Metastatic lymph node : S.C.C.
• Metastatic lymph node : Papillary
Carcinoma Thyroid .
Biopsy techniques
• Parallelism
• Needle
• Operator
• Monitor,brain and hands.

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