Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘neck’ Category

Vascular Anomalies, ISSVA Classification

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2 categories: vascular tumors or vascular malformations. Distinction determines therapy.

Vascular Tumors

  • infantile hemangiomas: grow rapidly after birth, GLUT1+
  • congenital hemangiomas (RICH and NICH): fully mature at birth, GLUT1-
  • Tufted angioma
  • Kaposiform hemangioendothelioma
  • Spindle cell hemangioendotheliomas
  • Dermatologic acquired vascular tumors

Vascular malformations (slow)

  • capillary malformation (port-wine stain, telangiectasia, angiokeratoma)
  • venous malformation
  • lymphatic malformation

Vascular malformations (fast)

  • arterial malformation
  • arteriovenous fistula
  • arteriovenous malformation

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Written by lmwong

April 23, 2012 at 12:57 pm

Soft Tissue Mass in Middle Ear

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  • Cholesteatoma
  • Chronic otitis media
  • Granulation tissue
  • Cholesterol granuloma
  • Glomus tympanicum tumor
  • Aberrant internal carotid artery
  • High or dehiscent jugular bulb

Written by lmwong

February 19, 2010 at 11:02 am

Posted in differential, head, neck

Cystic Pediatric Neck Masses

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Congenital:

  • Thyroglossal duct cyst – base of tongue, hyoid
  • 1st Brachial anomalies – between ear and mandible
  • 2nd brachial anomalies – mc, type 2 remnant of sinus of His, post to submandibular gland, anterior to scm, AL to vessels, brachiosaurus- otorenal syndrome
  • 3rd brachial anomalies – posterior or anterior triangle, cervical thymic cyst extend to mediastinum
  • 4th brachial anomalies – pyriform sinus fistula, inflammation next to thyroid
  • DermoId cysts – midline, paramidline, orbit, oral, nasal
  • Vascular – lymphatovenous malformations, locular, FFlevels

Acquired:

  • Suppuratibe adenopathy/abscess
  • Necrotic mets

Written by lmwong

January 16, 2010 at 11:08 am

Solid Pediatric Neck Masses

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  • Fibromatosis colli – muscle
  • Infectious adenitis (mc) – lymph nodes
  • Retropharyngeal abscess/phlegmon – air fluid level, rim enhance
  • Vascular: hemangioma (PHACE Syndrome)
  • Neurofibromas – dumb bells
  • Cervical thymus – remnant of 3rd brachial pouch
  • Teratomas – hetero, calcification
  • Lymphoma – conglomerate nodes, +gallium scan
  • Rhabdomyosarcoma – orbit or parameningeal
  • Neuroblastoma – most metastatic, metastatic nodes
  • Metastatic nodes – Nasopharyngeal, hepatoblastoma

Written by lmwong

January 16, 2010 at 11:07 am

Cystic Neck Masses in Pediatrics

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  1. Brachial Cleft Cyst: Type 2 most common (1-4)
  2. Ranula: impacted salivary gland
  3. Thyroglossal Duct Cyst: abarrent migration of thyroid tissue from tongue
  4. Venolymphatic Malformation: Fluid fluid levels, posterior to SCM
  5. Odontogenic Keratocyst: associated with teeth

Written by lmwong

September 11, 2008 at 5:54 pm

Posted in cystic, ent, neck, pediatrics

MRA Neck Dictation

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Indication: [x].

Technique: An MRA of the neck was performed using 2D and 3D time-of-flight techniques without the use of gadolinium.

Comparison: [x]

Findings: No hemodynamically significant stenosis of the common carotid, carotid bifurcation, or internal carotid arteries is seen. The extracranial portions of the vertebral basilar system are preserved without stenosis. No aneurysmal dilatation or dissection is seen.

Impression: Normal MRA of the neck.

Written by lmwong

April 9, 2008 at 11:03 am

C-Spine CT Dictation

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Indication: Neck injury.

Technique: Multiple contiguous 3 mm axial images were obtained from the skull base through the thoracic inlet without intravenous contrast. Reformats in the coronal and sagittal planes were also obtained.

Comparison: [x]

Findings: No prevertebral soft tissue swelling is seen. The cervical alignment is maintained without spondylolisthesis. No acute fracture is identified. The vertebral body and disk space heights are preserved. The odontoid process is intact.

Impression: [x]

Written by lmwong

April 9, 2008 at 11:01 am

Posted in ct, neck, neuro, sample dictation